Tracheostomy guidelines developed at a large academic medical center during the COVID-19 pandemic.
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During the SARS‐CoV‐2 pandemic, tracheostomy may be required for COVID‐19 patients requiring long‐term ventilation in addition to other conditions such as airway compromise from head and neck cancer.Abstract:
Author(s): David, Abel P; Russell, Marika D; El-Sayed, Ivan H; Russell, Matthew S | Abstract: BackgroundDuring the SARS-CoV-2 pandemic, tracheostomy may be required for COVID-19 patients requiring long-term ventilation in addition to other conditions such as airway compromise from head and neck cancer. As an aerosol-generating procedure, tracheostomy increases the exposure of health care workers to COVID-19 infection. Performing surgical tracheostomy and tracheostomy care requires a strategy that mitigates these risks and maintains the quality of patient care.MethodsThis study is a multidisciplinary review of institutional tracheostomy guidelines and clinical pathways. Modifications to support clinical decision making in the context of COVID-19 were derived by consensus and available evidence.ResultsModified guidelines for all phases of tracheostomy care at an academic tertiary care center in the setting of COVID-19 are presented.DiscussionDuring the various phases of the COVID-19 pandemic, clinicians must carefully consider the indications, procedural precautions, and postoperative care for tracheostomies. We present guidelines to mitigate risk to health care workers while preserving the quality of care.read more
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Early Outcomes From Early Tracheostomy for Patients With COVID-19.
Paul E. Kwak,Joseph R. Connors,Peter A. Benedict,Micah Timen,Binhuan Wang,Yan Zhang,Stephanie Youlios,Kimberly Sureau,Michael J. Persky,Samaan Rafeq,Luis F. Angel,Milan R. Amin +11 more
TL;DR: This cohort study from the first 2 months of the pandemic in New York City provides an opportunity to reconsider guidelines for tracheostomy for patients with COVID-19, and demonstrates noninferiority of early trachostomy and challenges recommendations to categorically delay or avoid tracheOSTomy.
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Percutaneous and Open Tracheostomy in Patients with COVID-19: Comparison and Outcomes of an Institutional Series in New York City.
Sallie Long,Alexander Chern,Noah Z. Feit,Sei Chung,Apoorva T. Ramaswamy,Carol Li,Victoria Cooley,Shanna S. Hill,Kapil Rajwani,Jonathan Villena-Vargas,Edward Scheneck,Brendon M. Stiles,Andrew B. Tassler +12 more
TL;DR: Tracheostomy under apneic conditions by either percutaneous or open technique can be safely performed in patients with respiratory failure due to COVID-19, and there were no significant differences in outcomes between per cutaneous and open methods.
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Tracheotomy in COVID-19 Patients: A Systematic Review and Meta-analysis of Weaning, Decannulation, and Survival.
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Indications and timing for tracheostomy in patients with SARS CoV2-related.
Emanuele Ferri,Francesca Boscolo Nata,Barbara Pedruzzi,Giovanni Campolieti,Francesco Scotto di Clemente,Fabio Baratto,Giovanni Cristalli +6 more
TL;DR: It is the opinion that tracheostomy in a stable or clinically improved COVID-19 patient should not be proposed before the 20th day after orotracheal intubation, in the face of possible risks of contagion for healthcare workers.
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