皇家外科学院多学科指南：COVID-19 机械通气患者选择性气管切开术置入
The Royal College of surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients.
机构信息
Department of Otolaryngology, Head and Neck Surgery, The Royal College of Surgeons, Ireland.
Department of Otolaryngology, Head and Neck Surgery, The Royal College of Surgeons, Ireland.
出版信息
Surgeon. 2021 Oct;19(5):e265-e269. doi: 10.1016/j.surge.2020.12.002. Epub 2020 Dec 29.
BACKGROUND
The current COVID-19 pandemic has placed enormous strain on healthcare systems worldwide. Understanding of COVID-19 is rapidly evolving. Pneumonia associated with COVID-19 may lead to respiratory failure requiring mechanical ventilation. The rise in patients requiring mechanical ventilation may lead to an increase in tracheostomies being performed in patients with COVID-19. Performing tracheostomy in patients with active SARS-CoV-2 infection poses a number of challenges.
METHODS
These guidelines were written following multidisciplinary agreement between Otolaryngology, Head and Neck Surgery, Respiratory Medicine and the Department of Anaesthetics and Critical Care Medicine in the Royal College of Surgeons in Ireland. A literature review was performed and a guideline for elective tracheostomy insertion in patients with COVID-19 proposed.
CONCLUSION
The decision to perform tracheostomy in patients with COVID-19 should be undertaken by senior members of the multidisciplinary team. Steps should be taken to minimise risks to healthcare workers.
背景
当前的 COVID-19 大流行给全球的医疗系统带来了巨大的压力。人们对 COVID-19 的认识正在迅速发展。COVID-19 相关肺炎可能导致需要机械通气的呼吸衰竭。需要机械通气的患者人数增加，可能导致 COVID-19 患者行气管切开术的数量增加。对有活动性 SARS-CoV-2 感染的患者进行气管切开术存在许多挑战。
方法
这些指南是在爱尔兰皇家外科医学院的耳鼻喉科、头颈外科、呼吸医学和麻醉与重症监护医学之间达成多学科一致意见后编写的。进行了文献回顾，并提出了 COVID-19 患者择期行气管切开术的指南。
结论
应让多学科团队的资深成员来决定 COVID-19 患者是否进行气管切开术。应采取措施尽量减少医护人员的风险。
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