Home > Research > Publications & Outputs > A novel percutaneous tracheostomy technique to ...

Electronic data

  • Novel_dilatational_percutaneous_tracheostomy_technique_to_reduce_aerosolisation_during_the_COVID-19_pandemic-_a_description_and_case_series_Accepted_Version

    Rights statement: This is the author’s version of a work that was accepted for publication in Trends in Anaesthesia and Critical Care. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Trends in Anaesthesia and Critical Care, ?, ?, 2021 DOI: 10.1016/j.tacc.2021.04.001

    Accepted author manuscript, 308 KB, PDF document

    Embargo ends: 13/04/22

    Available under license: CC BY-NC-ND: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Links

Text available via DOI:

View graph of relations

A novel percutaneous tracheostomy technique to reduce aerosolisation during the COVID-19 pandemic: A description and case series

Research output: Contribution to journalJournal articlepeer-review

E-pub ahead of print
Close
<mark>Journal publication date</mark>13/04/2021
<mark>Journal</mark>Trends in Anaesthesia and Critical Care
Publication StatusE-pub ahead of print
Early online date13/04/21
<mark>Original language</mark>English

Abstract

Background: COVID-19 is a global pandemic with many patients requiring prolonged mechanical ventilation. COVID-19 is associated with laryngeal oedema and a high rate of reintubation and difficult airway. Tracheostomy insertion is an aerosol generating procedure, so we strived to make our novel technique safe for operator and patient. Aim: To share our experience of a novel percutaneous tracheostomy technique, based on a case series of 18 patients with COVID-19 pneumonitis. Method: Our novel percutaneous tracheostomy technique is a landmark-based approach without bronchoscopic confirmation of the correct needle placement. Blunt dissection using tracheal dilators onto the tracheal rings facilitates first pass needle insertion into the trachea. The tracheal tube is retracted into the supraglottic airway, the cuff overinflated, and a wet throat pack inserted to reduce aerosolisation. Results: From March 2020 to May 2020, 38 patients with suspected or confirmed COVID-19 presented to Royal Bolton Hospital requiring invasive ventilation. 18 patients underwent percutaneous tracheostomy. 6 patients have been decannulated, 12 patients died. Mean time from intubation to tracheostomy was 6.1 days and from tracheostomy to decannulation 20.6 days. No operator developed COVID-19 symptoms. Conclusions: Despite the low numbers our novel technique appears to be safe, but confirmation requires a larger controlled trial. As an institution we have avoided difficulties with reintubation and reduced our drug usage. © 2021

Bibliographic note

This is the author’s version of a work that was accepted for publication in Trends in Anaesthesia and Critical Care. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Trends in Anaesthesia and Critical Care, ?, ?, 2021 DOI: 10.1016/j.tacc.2021.04.001