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新型冠状病毒肺炎患者气管切开术中改良负压隔离装置

Modified Negative Pressure Enclosure During Tracheostomy in Patients With COVID-19.

作者信息

Levy Dylan A, Boey Howard P, Leff Peter D

机构信息

5783Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA.

23891Midstate Medical Center, Hartford HealthCare, Meriden, CT, USA.

出版信息

Ear Nose Throat J. 2023 Feb;102(2):NP84-NP88. doi: 10.1177/0145561321991319. Epub 2021 Feb 2.

Abstract

COVID-19 also known as severe acute respiratory syndrome coronavirus 2 is the result of a highly transmissible coronavirus which can result in severe infection of the respiratory tract. The global pandemic which began in early 2020 has created a number of challenges for the medical community to contain the rate of transmission, especially to health care workers. A minority of the infected population will progress toward severe respiratory distress ultimately requiring mechanical ventilator assistance. Although preliminary data suggest a poor prognosis for those requiring ventilation support, there is a subgroup who will eventually be weaned off. As the pandemic evolves, this cohort of infected, chronically intubated and ventilated individuals will become more prevalent and may require tracheostomy to aid in recovery. Unfortunately, tracheostomy is an aerosol-generating procedure which poses high risks to all members within the operating room, as described by previous authors. There is an urgent need to explore and develop methods to maximize the safety of tracheostomy and other aerosol-generating procedures in order to reduce intraoperative transmission. In the present article, we present a modified technique for negative pressure enclosure in patients with COVID-19 who underwent tracheostomy.

摘要

新冠病毒病(COVID-19),也称为严重急性呼吸综合征冠状病毒2,是一种具有高度传染性的冠状病毒导致的疾病,可引发严重的呼吸道感染。始于2020年初的全球大流行给医学界控制传播速度带来了诸多挑战,尤其是对医护人员而言。少数受感染人群会发展为严重呼吸窘迫,最终需要机械通气支持。尽管初步数据显示,需要通气支持的患者预后较差,但有一部分患者最终能够脱机。随着疫情的发展,这一群体中受感染、长期插管和通气的个体将变得更加普遍,可能需要气管切开术来辅助康复。不幸的是,气管切开术是一种产生气溶胶的操作,如先前作者所述,对手术室中的所有人员都构成高风险。迫切需要探索和开发方法,以最大限度地提高气管切开术和其他产生气溶胶操作的安全性,以减少术中传播。在本文中,我们介绍了一种用于接受气管切开术的COVID-19患者负压封闭的改良技术。

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