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  • TracheotomyCOVID19May2020

    Rights statement: This is the peer reviewed version of the following article: Stubington, TJ, Mallick, AS, Garas, G, Stubington, E, Reddy, C, Mansuri, MS. Tracheotomy in COVID‐19 patients: Optimizing patient selection and identifying prognostic indicators. Head & Neck. 2020; 42: 1386– 1391. https://doi.org/10.1002/hed.26280 which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1002/hed.26280 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

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

Research output: Contribution to journalJournal articlepeer-review

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  • T.J. Stubington
  • A.S. Mallick
  • G. Garas
  • E. Stubington
  • C. Reddy
  • M.S. Mansuri
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<mark>Journal publication date</mark>1/07/2020
<mark>Journal</mark>Head Neck
Issue number7
Volume42
Number of pages6
Pages (from-to)1386-1391
Publication StatusPublished
Early online date22/05/20
<mark>Original language</mark>English

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 H2O 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 H2O 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.

Bibliographic note

This is the peer reviewed version of the following article: Stubington, TJ, Mallick, AS, Garas, G, Stubington, E, Reddy, C, Mansuri, MS. Tracheotomy in COVID‐19 patients: Optimizing patient selection and identifying prognostic indicators. Head & Neck. 2020; 42: 1386– 1391. https://doi.org/10.1002/hed.26280 which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1002/hed.26280 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.