Performing Bedside Surgical Tracheostomy On COVID-19 Patients At Intensive Care Unit-Our Experiences At A Tertiary Care Indian Teaching Hospital
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 1208-1217
Abstract
Background: Currently COVID-19 infection is a global challenge to the medical community. Acute respiratory distress syndrome (ARDS) and respiratory failure require mechanical ventilation. Tracheostomy is needed for prolonged ventilation as COVID-19 infections often escalates, so staying of the patient can be extended in ICU with ventilator.Objective: To evaluate the details of tracheostomy including patients profile, surgical steps, complications and precautions by health care workers at the intensive care unit (ICU) of the specially assigned hospital for COVID-19 patients.
Materials and Methods: This is a retrospective study in which 22 COVID-19 patients underwent bedside surgical tracheostomy at the ICU. Clinical patient’s profiles such as age, sex, co-morbidities, complication of the tracheostomy, ventilator withdrawal after tracheostomy and nosocomial infections of the health care workers related to tracheostomy were analyzed.
Result: Out of the 22 patients with COVID-19 infections those underwent tracheostomy, 16(72.72(%) were male and 6 (27.27%) were female with age ranged from 42 years to 75 years and a mean age of 64 years. The median duration from the day of the orotracheal intubation to the day of tracheostomy was 13 days.
Conclusion: Surgical tracheostomy on COVID-19 patients is a high risk aerosol generating procedure for health care workers. It should be performed with close association with otolaryngologists,
anesthesiologists and intensive care physicians along with adequate personal protective equipment (PPE) for smooth management of the general anesthesia and airway.
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