Tracheotomy in COVID-19 patients: Optimizing patient selection and identifying prognostic indicators.

ABSTRACT: BACKGROUND:Tracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity. METHODS:Prospective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined. RESULTS:Patients who sustained FiO2 ???50% and PEEP???8 cm H2 O in the 24?hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48?hours. CONCLUSION:Sustained FiO2 ???50% and PEEP???8 cm H2 O in the 48?hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity.

SUBMITTER: Stubington TJ 

PROVIDER: S-EPMC7280616 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature