Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Anesthesiology and Intensive Care Unit, University of Genoa, Italy.
Otolaryngol Head Neck Surg. 2020 Jul;163(1):135-137. doi: 10.1177/0194599820928963. Epub 2020 May 12.
The COVID-19 outbreak poses continued struggles due to the unprecedented number of patients admitted to intensive care units and the overwhelming need for mechanical ventilation. We report a preliminary case series of 32 patients with COVID-19 who underwent elective tracheostomies after a mean intubation period of 15 days (range, 9-21 days). The procedure was performed with percutaneous (10 cases) and open (22 cases) surgical techniques. Neither procedure-related complications nor viral transmission to health care workers was observed. Our preliminary experience supports the safety of tracheostomy, provided that appropriate protocols are strictly followed. The postoperative care is still debated, and, prudentially, our protocol includes tracheal tube change not before 2 weeks after tracheostomy, with cuff deflation and decannulation deferred until confirmation of negative SARS-CoV-2 test results. This is the first case series to report on such a rapidly evolving issue and might represent a source of information for clinicians worldwide who will soon be facing the same challenges.
由于需要大量患者入住重症监护病房和接受机械通气，COVID-19 疫情仍在持续。我们报告了一组 32 例 COVID-19 患者的初步病例系列，这些患者在平均插管 15 天后（范围为 9-21 天）接受了选择性气管切开术。该手术采用经皮（10 例）和开放性（22 例）手术技术进行。未观察到与手术相关的并发症或病毒向医护人员传播。我们的初步经验支持气管切开术的安全性，但前提是严格遵守适当的方案。术后护理仍存在争议，谨慎起见，我们的方案规定在气管切开术后 2 周内不得更换气管内管，充气套囊放气和拔管推迟至 SARS-CoV-2 检测结果阴性时再进行。这是首个报告此类快速发展问题的病例系列，可能为即将面临同样挑战的全球临床医生提供信息来源。
