Department of Otorhinolaryngology, Hospital Universitario El Bierzo, Médicos sin Fronteras s/n, 24401, Ponferrada, León, Spain.
Department of Medicine, Surgery and Anatomy, University of León, León, Spain.
Eur Arch Otorhinolaryngol. 2021 May;278(5):1605-1612. doi: 10.1007/s00405-020-06220-3. Epub 2020 Aug 4.
The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients.
A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp.
complications, achieved weaning and decannulation and survival.
We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4-42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients.
To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.
COVID-19 气管切开术的最佳策略和结果仍未得到解答。在我们的病例研究中，关键重点是评估气管切开术对插管 COVID-19 患者的结果。
对西班牙 120 家医院的 1890 例 COVID-19 患者进行了为期 7 周的多中心前瞻性观察性研究（2020 年 3 月 28 日至 5 月 15 日）。通过即时通讯应用程序 WhatsApp 以创新的方式收集数据。
并发症、脱机和拔管以及存活率。
我们进行了 1461 例手术（81.3%）和 429 例经皮气管切开术。气管切开术的中位时间是从气管插管开始的 12 天（4-42 天）。在 1 个月随访的截止时间对 1890 例患者中的 1616 例（85.5%）进行了密切随访，结果显示在 842 例（52.1%）患者中成功脱机，而 391 例（24.2%）仍在机械通气下，383 例（23.7%）患者死于 COVID-19。在成功脱机的 842 例患者中，有 683 例（81%）患者成功拔管。
据我们所知，这是最大的 COVID-19 患者气管切开术队列。重点是史无前例数量的气管切开术：7 周内 1890 例。在随访的患者中，超过一半的患者可以成功脱机。将近四分之一的气管切开患者死于 COVID-19。
