학술논문
Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study
Document Type
article
Author
Denise Battaglini; Francesco Missale; Irene Schiavetti; Marta Filauro; Francesca Iannuzzi; Alessandro Ascoli; Alberto Bertazzoli; Federico Pascucci; Salvatore Grasso; Francesco Murgolo; Simone Binda; Davide Maraggia; Giorgia Montrucchio; Gabriele Sales; Giuseppe Pascarella; Felice Eugenio Agrò; Gaia Faccio; Sandra Ferraris; Savino Spadaro; Giulia Falò; Nadia Mereto; Alessandro Uva; Jessica Giuseppina Maugeri; Bellissima Agrippino; Maria Vargas; Giuseppe Servillo; Chiara Robba; Lorenzo Ball; Francesco Mora; Alessio Signori; Antoni Torres; Daniele Roberto Giacobbe; Antonio Vena; Matteo Bassetti; Giorgio Peretti; Patricia R. M. Rocco; Paolo Pelosi
Source
Journal of Clinical Medicine, Vol 10, Iss 12, p 2651 (2021)
Subject
Language
English
ISSN
2077-0383
Abstract
Background: Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications. Methods: A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous). Results: The median time to tracheostomy was 15 (1–64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (p < 0.001) and percutaneous compared to surgical tracheostomy (p = 0.050). The rate of lower respiratory tract infections was higher with surgical versus percutaneous technique (p = 0.007). Conclusions: Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.