Patient Outcomes and Healthcare Worker Safety Related to Tracheostomy in Critically Ill Ventilated COVID-19-Positive Patients

Main Article Content

Jaymee Shell
Candice Griffin
Natalie Kozij
Rebecca Kruisselbrink

COVID-19, SARS-CoV2, ARDS, Tracheostomy

Abstract

Tracheostomy is an essential procedure for patients requiring prolonged mechanical ventilation; however, it is controversial in patients with COVID-19-related acute respiratory distress syndrome (ARDS). This multicenter case series was undertaken to determine if tracheostomies can be performed safely in COVID-19 patients without transmission of infection to healthcare providers. Seven COVID-19-positive patients that underwent tracheostomy were included in the study. Descriptive analysis was undertaken with a focus on patient-important outcomes (mortality, duration of ventilation, and time to discharge from the intensive care unit) as well as healthcare provider workplace absences due to COVID-19. All patients (100%) were discharged from hospital alive. Furthermore, healthcare providers developed symptomatic SARS-CoV2 infec-tion as a result of being involved in tracheostomy procedures for their patients. Tracheostomies are essential when providing critical care to patients with prolonged respiratory failure. This case series suggests that tra-cheostomy can be performed safely under conditions that protect healthcare workers in the COVID-19 era.



Résumé
La trachéostomie est une intervention indispensable chez les patients nécessitant une ventilation mécanique prolongée; toutefois, elle est controversée chez les patients atteints du syndrome de détresse respiratoire aiguë (SDRA) lié à la COVID-19. Cette série de cas multicentrique a été entreprise pour savoir si les trachéostomies peuvent être réalisées en toute sécurité chez les patients atteints de la COVID-19 sans transmission de l’infec-tion aux fournisseurs de soins. Sept patients positifs à la COVID-19 ayant subi une trachéostomie ont fait partie de cette étude. Une analyse descriptive a été réalisée en mettant l’accent sur les résultats importants pour les patients (mortalité, durée de la ventilation et temps écoulé avant la sortie de l’unité de soins intensifs), de même que sur les absences du travail des fournisseurs de soins à cause de la COVID-19. Tous les patients (100 %) ont obtenu leur congé de l’hôpital. En outre, des fournisseurs de soins ont contracté une infection symptomatique au SRAS-CoV-2 après avoir participé aux interventions de trachéostomie pratiquées sur leurs patients. La trachéostomie est indispensable lorsque des soins critiques sont prodigués aux patients présentant une insuffisance respiratoire prolongée. Cette série de cas laisse entendre que la trachéostomie peut être effectuée en toute sécurité dans des conditions qui protègent les travailleurs de la santé à l’ère de la pandémie de COVID-19.

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