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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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Tracheotomy in COVID-19 patients
T2 - Optimizing patient selection and identifying prognostic indicators
AU - Stubington, T.J.
AU - Mallick, A.S.
AU - Garas, G.
AU - Stubington, E.
AU - Reddy, C.
AU - Mansuri, M.S.
N1 - 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.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - coronavirus
KW - COVID-19
KW - pandemic
KW - SARS-CoV-2
KW - tracheotomy
U2 - 10.1002/hed.26280
DO - 10.1002/hed.26280
M3 - Journal article
C2 - 32441351
VL - 42
SP - 1386
EP - 1391
JO - Head Neck
JF - Head Neck
SN - 1043-3074
IS - 7
ER -