Safe tracheostomy in COVID-19 patients: a case series

Authors

  • Melissa K. Meghpara Department of Surgery, Flushing Hospital Medical Center, Flushing, NY, USA
  • Bhavana Devanabanda St. George’s University School of Medicine, Grenada, West Indies
  • Mercy Jimenez Department of Surgery, Flushing Hospital Medical Center, Flushing, NY, USA
  • Martine A. Louis Department of Surgery, Flushing Hospital Medical Center, Flushing, NY, USA
  • Neil Mandava Department of Surgery, Flushing Hospital Medical Center, Flushing, NY, USA

DOI:

https://doi.org/10.18203/2349-2902.isj20203257

Keywords:

Tracheostomy, COVID-19, Bedside procedure, Aerosolization, Personal protective equipment

Abstract

The coronavirus (COVID-19) pandemic has led to a critical need in treating severe respiratory disease while providing adequate protection to healthcare workers. Critically ill COVID-19 patients have required prolonged intubation and mechanical ventilation, not limited to those with multiple comorbidities or the elderly. At the height of the pandemic in New York City; our institution intubated 192 COVID-19 patients. Many institutions have avoided performing tracheostomy in this population due to high risk of virus aerosolization. This study is a retrospective, IRB approved, single center case series of 14 consecutive tracheostomies in COVID-19 patients at a community hospital in Flushing, New York City. Data from 1 March to 31 May 2020 was collected from electronic medical records. All COVID-19 positive patients undergoing tracheostomy were included; patients undergoing tracheostomy that were not COVID-19 positive were excluded. Fourteen patients underwent tracheostomy during the study period. Average age was 62 and 64.3% were male (n=9). Hispanic males represented 50% of patients undergoing tracheostomy and 71.4% were from home. Average days from initial intubation to tracheostomy was 20.6, ranging from 12 to 43 days. With the exception of two patients, all underwent a single intubation. No involved operating room staff became ill during or after these procedures. Tracheostomy may be safely performed in COVID-19 patients while minimizing risk to staff; however, patient outcomes may not be significantly altered. Further research is needed to determine the optimal timing and overall benefit of tracheostomy in this population.

Author Biography

Melissa K. Meghpara, Department of Surgery, Flushing Hospital Medical Center, Flushing, NY, USA

Chief general surgery resident

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Published

2020-07-23

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Section

Case Series