학술논문
PERCUTANEOUS DILATATIONAL TRACHEOSTOMY IN COVID-19 PATIENTS IN THE COVID HOSPITAL INTENSIVE CARE UNIT: THE UNIVERSITY CLINICAL CENTER OF VOJVODINA EXPERIENCE/PERKUTANA DILATACIJSKA TRAHEOSTOMIJA U BOLESNIKA S COVID-19 U JEDINICI INTENZIVNOG LIJECENJA: ISKUSTVO COVID BOLNICE KLINICKOG CENTRA VOJVODINE
Original Scientific Paper
Original Scientific Paper
Document Type
Report
Author
Source
Acta Clinica Croatica. March 15, 2023, Vol. 62 Issue S1, p55, 8 p.
Subject
Language
English
ISSN
0353-9466
Abstract
Introduction The corona virus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome virus 2 (SARS CoV-2). It can be clinically manifiested as mild, moderate, severe and critical [...]
Patients with acute respiratory distress syndrome due to COVID-19 require intensive care unit (ICU) admission with consecutive endotracheal intubation and invasive mechanical ventilation. In patients with long-term mechanical ventilation, percutaneous dilatational tracheostomy (PDT) may be considered. This retrospective analysis includes clinical data on patients treated at the ICUs of the COVID Hospital of the Clinical Center of Vojvodina in the period from September 3, 2021 to May 1, 2022, and underwent PDT. Patients were predominantly male (n=48; 65.8%). Weaning from mechanical ventilation was achieved in 31 (42.5%) and decannulation in 25 (34.2%) patients. The mean time from polymerase chain reaction SARS CoV-2 positivity until PDT was 15.59[+ or -]6.85 days. The mean time of endotracheal intubation before the PDT procedure was 7.37[+ or -]4.89 days. The mean weaning time from mechanical ventilation was 10.45[+ or -]7.92 days. Twenty-five (34.2%) patients were decannulated at the mean time of 19.60[+ or -]11.81 days. The complications were tracheostomy related bleeding (2 patients), pneumothorax (4 patients), subcutaneous emphysema (1 patient) and cricoid cartilage injury (1 patient). PDT is a simple, safe, and effective procedure performed in COVID-19 patients in the ICU. Key words: COVID-19; Percutaneous dilatational tracheostomy; Mechanical ventilation; Decannulation Bolesnici sa sindromom akutnog respiracijskog distresa zbog COVID-19 zahtijevaju prijam u jedinicu intenzivnog lijecanja (JIL) s posljedicnom endotrahealnom intubacijom i invazivnom mehanickom ventilacijom. U bolesnika na produzenoj mehanickoj ventilaciji potrebno je razmotriti perkutanu dilatacijsku traheostomiju (PDT). Ova retrospektivna analiza ukljucuje klinicke podatke bolesnika koji su lijeceni u jedinici intenzivnog lijecenja u COVID bolnici Klinickog centra Vojvodine u razdoblju od 3. rujna 2021. do 1. svibnja 2022. i koji su bili podvrgnuti PDT-u. Bolesnici su pretezito bili muskarci (n=48; 65,8%). Odvajanje od mehanicke ventilacije je postignuto u 31 (42,5%) i dekanilacija u 25 (34,5%) bolesnika. Srednje vrijeme od dokazanog pozitiviteta PCR testom na SARS CoV-2 do PDT je bilo 15,59[+ or -]6,85 dana. Srednje vrijeme endotrahealne intubacije prije postupka PDT je bilo 7,37[+ or -]4,89 dana. Srednje vrijeme odvajanja od mehanicke ventilacije je bilo 10,45[+ or -]7,92 dana. Dekanilirano je bilo 25 (34,5%) bolesnika, a srednje vrijeme je bilo 19,60[+ or -]11,81 dana. Komplikacije su bile krvarenje povezano uz traheostomu (2 bolesnika), pneumotoraks (4 bolesnika), subkutani emfzem (1 bolesnik) i ozljeda krikoidne hrskavice (1 bolesnik). PDT je jednostavan, siguran i ucinkovit postupak u bolesnika s COVID-19 u JIL-u. Kljucne rijeci: COVID-19; Perkutana dilatacijska traheostomija; Mehanicka ventilacija; Dekaniliranje
Patients with acute respiratory distress syndrome due to COVID-19 require intensive care unit (ICU) admission with consecutive endotracheal intubation and invasive mechanical ventilation. In patients with long-term mechanical ventilation, percutaneous dilatational tracheostomy (PDT) may be considered. This retrospective analysis includes clinical data on patients treated at the ICUs of the COVID Hospital of the Clinical Center of Vojvodina in the period from September 3, 2021 to May 1, 2022, and underwent PDT. Patients were predominantly male (n=48; 65.8%). Weaning from mechanical ventilation was achieved in 31 (42.5%) and decannulation in 25 (34.2%) patients. The mean time from polymerase chain reaction SARS CoV-2 positivity until PDT was 15.59[+ or -]6.85 days. The mean time of endotracheal intubation before the PDT procedure was 7.37[+ or -]4.89 days. The mean weaning time from mechanical ventilation was 10.45[+ or -]7.92 days. Twenty-five (34.2%) patients were decannulated at the mean time of 19.60[+ or -]11.81 days. The complications were tracheostomy related bleeding (2 patients), pneumothorax (4 patients), subcutaneous emphysema (1 patient) and cricoid cartilage injury (1 patient). PDT is a simple, safe, and effective procedure performed in COVID-19 patients in the ICU. Key words: COVID-19; Percutaneous dilatational tracheostomy; Mechanical ventilation; Decannulation Bolesnici sa sindromom akutnog respiracijskog distresa zbog COVID-19 zahtijevaju prijam u jedinicu intenzivnog lijecanja (JIL) s posljedicnom endotrahealnom intubacijom i invazivnom mehanickom ventilacijom. U bolesnika na produzenoj mehanickoj ventilaciji potrebno je razmotriti perkutanu dilatacijsku traheostomiju (PDT). Ova retrospektivna analiza ukljucuje klinicke podatke bolesnika koji su lijeceni u jedinici intenzivnog lijecenja u COVID bolnici Klinickog centra Vojvodine u razdoblju od 3. rujna 2021. do 1. svibnja 2022. i koji su bili podvrgnuti PDT-u. Bolesnici su pretezito bili muskarci (n=48; 65,8%). Odvajanje od mehanicke ventilacije je postignuto u 31 (42,5%) i dekanilacija u 25 (34,5%) bolesnika. Srednje vrijeme od dokazanog pozitiviteta PCR testom na SARS CoV-2 do PDT je bilo 15,59[+ or -]6,85 dana. Srednje vrijeme endotrahealne intubacije prije postupka PDT je bilo 7,37[+ or -]4,89 dana. Srednje vrijeme odvajanja od mehanicke ventilacije je bilo 10,45[+ or -]7,92 dana. Dekanilirano je bilo 25 (34,5%) bolesnika, a srednje vrijeme je bilo 19,60[+ or -]11,81 dana. Komplikacije su bile krvarenje povezano uz traheostomu (2 bolesnika), pneumotoraks (4 bolesnika), subkutani emfzem (1 bolesnik) i ozljeda krikoidne hrskavice (1 bolesnik). PDT je jednostavan, siguran i ucinkovit postupak u bolesnika s COVID-19 u JIL-u. Kljucne rijeci: COVID-19; Perkutana dilatacijska traheostomija; Mehanicka ventilacija; Dekaniliranje