Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study

被引：26

作者：

Battaglini, Denise ^{[1
,2
]}

Missale, Francesco ^{[3
]}

Schiavetti, Irene ^{[4
]}

Filauro, Marta ^{[3
]}

Iannuzzi, Francesca ^{[1
,5
]}

Ascoli, Alessandro ^{[3
]}

Bertazzoli, Alberto ^{[6
]}

Pascucci, Federico ^{[6
]}

Grasso, Salvatore ^{[7
]}

Murgolo, Francesco ^{[7
]}

Binda, Simone ^{[8
]}

Maraggia, Davide ^{[8
]}

Montrucchio, Giorgia ^{[9
]}

Sales, Gabriele ^{[9
]}

Pascarella, Giuseppe ^{[10
]}

Agro, Felice Eugenio ^{[10
]}

Faccio, Gaia ^{[11
]}

Ferraris, Sandra ^{[11
]}

Spadaro, Savino ^{[12
]}

Falo, Giulia ^{[12
]}

Mereto, Nadia ^{[13
]}

Uva, Alessandro ^{[13
]}

Maugeri, Jessica Giuseppina ^{[14
]}

Agrippino, Bellissima ^{[14
]}

Vargas, Maria ^{[15
]}

Servillo, Giuseppe ^{[15
]}

Robba, Chiara ^{[1
,5
]}

Ball, Lorenzo ^{[1
,5
]}

Mora, Francesco ^{[3
]}

Signori, Alessio ^{[4
]}

Torres, Antoni ^{[16
]}

Giacobbe, Daniele Roberto ^{[17
,18
]}

Vena, Antonio ^{[18
]}

Bassetti, Matteo ^{[17
,18
]}

Peretti, Giorgio ^{[3
]}

Rocco, Patricia R. M. ^{[19
,20
]}

Pelosi, Paolo ^{[1
,5
]}

机构：

[1] San Martino Policlin Hosp, IRCCS Oncol & Neurosci, Anesthesia & Intens Care, I-16132 Genoa, Italy

[2] Univ Barcelona, Dept Med, Barcelona 08007, Spain

[3] Univ Genoa, San Martino Polidin Hosp, IRCCS Oncol & Neurosci, Dept Otorhinolaryngol Head & Neck Surg, I-16132 Genoa, Italy

[4] Univ Genoa, Dept Hlth Sci, Sect Biostat, I-16132 Genoa, Italy

[5] Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, I-16132 Genoa, Italy

[6] ASST Spedali Civili Brescia, Div Anesthesiol & Intens Care Unit 1, I-25123 Brescia, Italy

[7] Univ Bari Aldo Moro, Osped Policlin, Sez Anestesiol & Rianimaz, Dipartimento Emergenza & Trapianti Organo DETO, I-70124 Bari, Italy

[8] Univ Hosp, Osped Circolo, Anaesthesia & Intens Care Dept, I-21100 Varese, Italy

[9] Citta Salute & Sci Hosp, Dept Anesthesia Intens Care & Emergency, Anestesia & Rianimaz 1U, I-10121 Turin, Italy

[10] Univ Campus Biomed Roma, Dept Anaesthesia Intens Care & Pain Management, Via Alvaro del Portillo 21, I-00128 Rome, Italy

[11] Osped Treviglio Caravaggio, UO Anestesia & Rianimaz, I-24047 Treviglio, Italy

[12] Univ Ferrara, Fac Med, Dept Morphol Surg & Expt Med, I-44121 Ferrara, Italy

[13] Osped Villa Scassi, Anestesia & Rianimaz, I-16132 Genoa, Italy

[14] Garibaldi Ctr Hosp, ARNAS Garibaldi, Anesthesia & Intens Care, I-95100 Catania, Italy

[15] Univ Napoli Federico II, Dipartimento Neurosci Sci Riprod & Odontostomatol, I-80126 Naples, Italy

[16] Univ Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Hosp Clin Barcelona, Dept Pulmonol,SGR Ciber Enfermedades Resp CIBERES, Barcelona 08007, Spain

[17] Univ Genoa, Dipartimento Sci Salute DISSAL, I-16132 Genoa, Italy

[18] Ist Ricovero & Cura Carattere Sci IRCCS Oncol & N, Clin Malattie Infett, I-16132 Genoa, Italy

[19] Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Lab Pulm Invest, BR-21941 Rio De Janeiro, Brazil

[20] Minist Sci Technol & Innovat, COVID 19 Virus Network RedeVirus MCTI, BR-70007 Brasilia, DF, Brazil

来源：

JOURNAL OF CLINICAL MEDICINE | 2021年 / 10卷 / 12期

关键词：

tracheostomy; COVID-19; SARS-CoV-2; intensive care; coronavirus; surgical technique; percutaneous; CRITICALLY-ILL PATIENTS; RECEIVING MECHANICAL VENTILATION; CORONAVIRUS DISEASE 2019; INTENSIVE-CARE-UNIT; SURGICAL TRACHEOSTOMY; HOSPITAL MORTALITY; RANDOMIZED-TRIAL; LATE TRACHEOTOMY; ADULT PATIENTS; ICU PATIENTS;

D O I：

10.3390/jcm10122651

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：14

共 44 条

[1] Novel Percutaneous Tracheostomy for Critically Ill Patients With COVID-19 [J].

Angel, Luis ;

Kon, Zachary N. ;

Chang, Stephanie H. ;

Rafeq, Samaan ;

Shekar, Saketh Palasamudram ;

Mitzman, Brian ;

Amoroso, Nancy ;

Goldenberg, Ronald ;

Sureau, Kimberly ;

Smith, Deane E. ;

Cerfolio, Robert J. .

ANNALS OF THORACIC SURGERY, 2020, 110 (03) :1006-1011

[2] Percutaneous translaryngeal versus surgical tracheostomy: A randomized trial with 1-yr double-blind follow-up [J].

Antonelli, M ;

Michetti, V ;

Di Palma, A ;

Conti, G ;

Pennisi, MA ;

Arcangeli, A ;

Montini, L ;

Bocci, MG ;

Bello, G ;

Almadori, G ;

Paludetti, G ;

Proietti, R .

CRITICAL CARE MEDICINE, 2005, 33 (05) :1015-1020

[3] Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries [J].

Bellani, Giacomo ;

Laffey, John G. ;

Pham, Tai ;

Fan, Eddy ;

Brochard, Laurent ;

Esteban, Andres ;

Gattinoni, Luciano ;

van Haren, Frank ;

Larsson, Anders ;

McAuley, Daniel F. ;

Ranieri, Marco ;

Rubenfeld, Gordon ;

Thompson, B. Taylor ;

Wrigge, Hermann ;

Slutsky, Arthur S. ;

Pesenti, Antonio .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 315 (08) :788-800

[4] Tracheostomy During the COVID-19 Pandemic: Comparison of International Perioperative Care Protocols and Practices in 26 Countries [J].

Bier-Laning, Carol ;

Cramer, John D. ;

Roy, Soham ;

Palmieri, Patrick A. ;

Amin, Ayman ;

Anon, Jose Manuel ;

Bonilla-Asalde, Cesar A. ;

Bradley, Patrick J. ;

Chaturvedi, Pankaj ;

Cognetti, David M. ;

Dias, Fernando ;

Di Stadio, Arianna ;

Fagan, Johannes J. ;

Feller-Kopman, David J. ;

Hao, Sheng-Po ;

Kim, Kwang Hyun ;

Koivunen, Petri ;

Loh, Woei Shyang ;

Mansour, Jobran ;

Naunheim, Matthew R. ;

Schultz, Marcus J. ;

Shang, You ;

Sirjani, Davud B. ;

St John, Maie A. ;

Tay, Joshua K. ;

Vergez, Sebastien ;

Weinreich, Heather M. ;

Wong, Eddy W. Y. ;

Zenk, Johannes ;

Rassekh, Christopher H. ;

Brenner, Michael J. .

OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2021, 164 (06) :1136-1147

[5] Early tracheotomy versus prolonged endotracheal intubation in unselected severely ill ICU patients [J].

Blot, Francois ;

Similowski, Thomas ;

Trouillet, Jean-Louis ;

Chardon, Patrick ;

Korach, Jean-Michel ;

Costa, Marie-Alyette ;

Journois, Didier ;

Thiery, Guillaume ;

Fartoukh, Muriel ;

Pipien, Isabelle ;

Bruder, Nicolas ;

Orlikowski, David ;

Tankere, Frederic ;

Durand-Zaleski, Isabelle ;

Auboyer, Christian ;

Nitenberg, Gerard ;

Holzapfel, Laurent ;

Tenaillon, Alain ;

Chastre, Jean ;

Laplanche, Agnes .

INTENSIVE CARE MEDICINE, 2008, 34 (10) :1779-1787

[6] Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits [J].

Botti, Cecilia ;

Lusetti, Francesca ;

Neri, Tommaso ;

Peroni, Stefano ;

Castellucci, Andrea ;

Salsi, Pierpaolo ;

Ghidini, Angelo .

AURIS NASUS LARYNX, 2021, 48 (03) :511-517

[7] Safety and 30-day outcomes of tracheostomy for COVID-19: a prospective observational cohort study [J].

Breik, Omar ;

Sharma, Neil ;

Dawson, Camilla ;

Bangash, Mansoor N. ;

Idle, Matthew ;

Isherwood, Peter ;

Jennings, Christopher ;

Keene, Damian ;

Manji, Mav ;

Martin, Tim ;

Moss, Rob ;

Murphy, Nick ;

Parekh, Dhruv ;

Parmar, Sat ;

Patel, Jaimin ;

Pracy, Paul ;

Praveen, Prav ;

Richardson, Carla ;

Richter, Alex ;

Sachdeva, Rajneesh ;

Shields, Adrian ;

Siddiq, Somiah ;

Smart, Simon ;

Tasker, Laura ;

Nankivell, Paul .

BRITISH JOURNAL OF ANAESTHESIA, 2020, 125 (06) :872-879

[8] Early versus late tracheostomy after decompressive craniectomy for stroke [J].

Catalino, Michael P. ;

Lin, Feng-Chang ;

Davis, Nathan ;

Anderson, Keith ;

Olm-Shipman, Casey ;

Jordan, J. Dedrick .

JOURNAL OF INTENSIVE CARE, 2018, 6

[9] Outcomes After Tracheostomy in COVID-19 Patients [J].

Chao, Tiffany N. ;

Harbison, Sean P. ;

Braslow, Benjamin M. ;

Hutchinson, Christoph T. ;

Rajasekaran, Karthik ;

Go, Beatrice C. ;

Paul, Ellen A. ;

Lambe, Leah D. ;

Kearney, James J. ;

Chalian, Ara A. ;

Cereda, Maurizio F. ;

Martin, Niels D. ;

Haas, Andrew R. ;

Atkins, Joshua H. ;

Rassekh, Christopher H. .

ANNALS OF SURGERY, 2020, 272 (03) :E181-E186

[10] Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis [J].

Delaney, Anthony ;

Bagshaw, Sean M. ;

Nalos, Marek .

CRITICAL CARE, 2006, 10 (02)

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