Department of Oral and Maxillofacial Surgery, North Manchester General Hospital, United Kingdom.
Department of Oral and Maxillofacial Surgery, North Manchester General Hospital, United Kingdom.
Oral Oncol. 2020 Jul;106:104767. doi: 10.1016/j.oraloncology.2020.104767. Epub 2020 May 3.
Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices implemented by senior clinicians. Here, we report on our early experience and outcomes with open tracheostomies in a cohort of COVID-19 patients. We outline the criteria that guide decision making and explore the challenges faced by our intensive care colleagues in the management of these patients. The cohort was 100% male with 90% of them having a raised Body Mass Index (BMI) and other comorbidities (hypertension and diabetes). 60% have been decannulated and have been stepped down the intensive care unit. We recorded no surgical complications or adverse events. The service to date has been shown to be effective, safe, largely reproducible and reflective.
外科气管切开术在重症监护病房治疗的 COVID-19 患者的脱机过程中发挥作用。需要多学科团队方法（MDT）来做出决策。这一过程通过资深临床医生实施的特定标准操作实践得到增强。在这里，我们报告了 COVID-19 患者中开放性气管切开术的早期经验和结果。我们概述了指导决策的标准，并探讨了我们重症监护同事在管理这些患者时面临的挑战。该队列的 100%为男性，90%的人 BMI 升高，且有其他合并症（高血压和糖尿病）。60%的患者已拔管，并已从重症监护病房降级。我们未记录到手术并发症或不良事件。迄今为止，该服务已被证明是有效、安全、在很大程度上可重复且具有借鉴意义的。
