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关于新冠疫情期间气管切开术指南与建议的系统评价

"A Systematic Review on Guidelines and Recommendations for Tracheostomy During COVID-19 Pandemic".

作者信息

Shah Rahulkumar, Priyadarshini G, Parsana Monil

机构信息

Department of ENT, Pramukhswami Medical College, Karamsad, Anand, Gujarat 388325 India.

Department of ENT, Pandit Dindayal Upadhyay Medical College, Rajkot, Gujarat India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2947-2958. doi: 10.1007/s12070-021-02517-9. Epub 2021 Apr 29.

Abstract

World is under threat of COVID-19 pandemic, associated with many numbers of critically ill patients. To manage these intubated patients there are need of more ventilators but world is not prepared for this type of situation and there are lacunae of such arrangements in most of the countries. As we know patients cannot be intubated for long time and they should be given preference to alternative airway in the form of tracheostomy. COVID-19 is aerosol transmitted disease which lead to indeed challenge to health care providers to safely perform tracheostomy and provide post tracheostomy care to these patients with minimising risks of nosocomial transmission to themselves and accompanying nursing staff. There are so many guidelines and recommendations for the timing, desired place of tracheostomy, change in tracheostomy steps related to conventional method and the subsequent management of patients. So, the aim of this systematic review is to give a brief review of available data on COVID-19 related to the timing, personal protections, operative steps modifications, and subsequent post tracheostomy care during this pandemic.

摘要

世界正面临新冠疫情的威胁,这与大量危重症患者相关。为了管理这些插管患者,需要更多的呼吸机,但世界并未为此类情况做好准备,大多数国家在这方面的安排存在缺陷。我们知道,患者不能长时间插管,应以气管造口术的形式为他们优先选择替代气道。新冠病毒是通过气溶胶传播的疾病,这确实给医护人员带来了挑战,要求他们安全地实施气管造口术,并为这些患者提供气管造口术后护理,同时将对自身和随行护理人员的医院内传播风险降至最低。关于气管造口术的时机、理想实施地点、与传统方法相关的气管造口术步骤变化以及患者的后续管理,有许多指南和建议。因此,本系统评价的目的是简要回顾在本次疫情期间与新冠病毒相关的关于气管造口术的时机、个人防护、手术步骤修改以及气管造口术后护理的现有数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aaca/9702171/b345e10525d5/12070_2021_2517_Fig1_HTML.jpg

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