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新型冠状病毒肺炎患者气管切开术的时机与临床结局

Timing and clinical outcomes of tracheostomy in patients with COVID-19.

作者信息

Ahn D, Lee G J, Choi Y S, Park J W, Kim J K, Kim E J, Lee Y H

机构信息

Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University, Daegu, Korea.

Department of Otolaryngology-Head and Neck Surgery, Yeungnam University, Daegu, Korea.

出版信息

Br J Surg. 2021 Jan 27;108(1):e27-e28. doi: 10.1093/bjs/znaa064.

DOI:10.1093/bjs/znaa064
PMID:33640938
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7799185/
Abstract

In this retrospective multicentre cohort study that included 27 COVID-19 patients who underwent tracheostomy, the mean time between intubation and tracheostomy was 15.8 days and the negative conversion time of COVID-19 was 43.1 days. Eleven patients (40.7%) died of COVID-19 and the use of percutaneous dilatation tracheostomy was significantly associated with in-hospital death. Timely tracheostomy could be performed in COVID-19 patients, regardless of duration of intubation or positivity of COVID-19 test, with an open surgical tracheostomy as a preferable technique.

摘要

在这项回顾性多中心队列研究中,纳入了27例接受气管切开术的新冠肺炎患者,插管至气管切开术的平均时间为15.8天,新冠肺炎核酸转阴时间为43.1天。11例患者(40.7%)死于新冠肺炎,经皮扩张气管切开术的使用与院内死亡显著相关。新冠肺炎患者无论插管时间长短或新冠病毒检测结果如何,均可及时进行气管切开术,开放式外科气管切开术是更可取的技术。

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本文引用的文献

1
COVIDTrach; the outcomes of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK: Interim Report.新冠气管切开术;英国接受气管切开术的新冠病毒肺炎机械通气患者的结局:中期报告
Br J Surg. 2020 Nov;107(12):e583-e584. doi: 10.1002/bjs.12020. Epub 2020 Sep 17.
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Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline.COVID-19 大流行期间的气管切开护理和拔管。多学科临床实践指南。
Eur Arch Otorhinolaryngol. 2021 Feb;278(2):313-321. doi: 10.1007/s00405-020-06126-0. Epub 2020 Jun 17.
3
Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic.重症监护病房中的气管切开术:全球 COVID-19 大流行期间的指南。
Am J Otolaryngol. 2020 Sep-Oct;41(5):102578. doi: 10.1016/j.amjoto.2020.102578. Epub 2020 Jun 1.
4
Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP).多学科指导以确保 COVID-19 大流行期间的安全气管切开术护理:NHS 国家患者安全改进计划 (NatPatSIP)。
Anaesthesia. 2020 Dec;75(12):1659-1670. doi: 10.1111/anae.15120. Epub 2020 Jun 5.
5
Tracheostomy protocols during COVID-19 pandemic.COVID-19 大流行期间的气管切开术方案。
Head Neck. 2020 Jun;42(6):1297-1302. doi: 10.1002/hed.26192. Epub 2020 May 2.