Early vs. late tracheostomy in ventilated COVID-19 patients – A retrospective study
American Journal of Otolaryngology - Head and Neck Medicine and Surgery Jun 10, 2021
Livnehac N, Mansourab J, Lernercd RK, et al. - One of the most common surgical procedures performed on ventilated COVID-19 patients is tracheostomy, however, controversies remain concerning the appropriate timing for operating. Hence, researchers sought to determine if and how early tracheostomy affects mortality and decannulation and investigated changes in ventilation parameters, vasopressors and sedatives dosages immediately after the procedure. They studied a retrospective cohort of 38 ventilated COVID-19 patients in whom tracheostomy was conducted. Of these patients, half underwent tracheostomy within 7 days of intubation and the rest underwent tracheostomy after 8 days or more. The early tracheostomy group had significantly higher decannulation rates while non-significantly lower mortality rates when compared with the late tracheostomy group. In the immediate days after the tracheostomy, significantly lower PEEP while significantly higher tidal volume was recorded when compared with that noted prior to the procedure. No participating staff members (surgeons, anesthesiologists, nurses) contracted the infection with SARS-CoV-2 virus.
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