Otorhinolaryngology Unit, Azienda Socio-Sanitaria Territoriale - (ASST) della Brianza, Vimercate (MB), Italy.
Anesthesiology Unit, Azienda Socio-Sanitaria Territoriale - (ASST) della Brianza, Vimercate (MB), Italy.
Acta Otorhinolaryngol Ital. 2021 Oct;41(5):389-394. doi: 10.14639/0392-100X-N1435.
COVID-19 respiratory insufficiency has augmented demand of tracheostomies in intubated patients. Herein, we analyse our experience with suspension laryngoscopy-assisted percutaneous dilatational tracheostomy (SL-PDT) to assess the safety for both healthcare personnel and patients.
We conducted a retrospective review of all patients who underwent SL-PDT in the Intensive Care Unit (ICU) between March 13 and April 17, 2020 (first peak of SARS-CoV-2 pandemic).
We included 28 SL-PDTs conducted in the ICU by a single operator using standard personal protective equipment (PPE) for high-risk procedures. The average procedure time was 30 minutes. Intraoperative complications were few, mild and promptly resolved. No operators were infected after the procedure.
SL-PDT is a safe and quick technique: it is preferable to open surgical procedures, where air-flow cessation cannot be achieved and droplet emission is high. The cost/benefit ratio is low. A disadvantage is the need for an ENT surgeon who is familiar with direct laryngoscopy, with the main difficulty being the exposure of the upper airways. Minimal air leakage and good control of occasional bleeding makes it a safe procedure for the patient and medical personnel alike.
COVID-19 导致呼吸功能不全，增加了气管切开术在插管患者中的需求。在此，我们分析了我们在经悬雍垂喉镜辅助经皮扩张气管切开术（SL-PDT）方面的经验，以评估其对医护人员和患者的安全性。
我们对 2020 年 3 月 13 日至 4 月 17 日（SARS-CoV-2 大流行的第一个高峰期间）在重症监护病房（ICU）中进行的所有 SL-PDT 患者进行了回顾性分析。
我们纳入了 28 例由一名操作者在 ICU 中使用标准的高危程序个人防护设备（PPE）进行的 SL-PDT。平均手术时间为 30 分钟。术中并发症少、程度轻且迅速得到解决。术后没有操作者感染。
SL-PDT 是一种安全、快速的技术：它优于开放式手术，因为开放式手术无法实现气流停止且飞沫排放高。成本/效益比低。缺点是需要熟悉直接喉镜的耳鼻喉科医生，主要困难是暴露上呼吸道。微小的空气泄漏和对偶尔出血的良好控制使它成为一种对患者和医务人员都安全的手术。
