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

[41] Elective Tracheostomy During Mechanical Ventilation in Patients Affected by COVID-19: Preliminary Case Series From Lombardy, Italy [J].

Turri-Zanoni, Mario ;

Battaglia, Paolo ;

Czaczkes, Camilla ;

Pelosi, Paolo ;

Castelnuovo, Paolo ;

Cabrini, Luca .

OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2020, 163 (01) :135-137

[42] Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy [J].

Vena, Antonio ;

Giacobbe, Daniele Roberto ;

Di Biagio, Antonio ;

Mikulska, Malgorzata ;

Taramasso, Lucia ;

De Maria, Andrea ;

Ball, Lorenzo ;

Brunetti, Iole ;

Loconte, Maurizio ;

Patroniti, Nicolo A. ;

Robba, Chiara ;

Delfino, Emanuele ;

Dentone, Chiara ;

Magnasco, Laura ;

Nicolini, Laura ;

Toscanini, Federica ;

Bavastro, Martina ;

Cerchiaro, Matteo ;

Barisione, Emanuela ;

Giacomini, Mauro ;

Mora, Sara ;

Baldi, Federico ;

Balletto, Elisa ;

Berruti, Marco ;

Briano, Federica ;

Sepulcri, Chiara ;

Dettori, Silvia ;

Labate, Laura ;

Mirabella, Michele ;

Portunato, Federica ;

Pincino, Rachele ;

Russo, Chiara ;

Tutino, Stefania ;

Pelosi, Paolo ;

Bassetti, Matteo .

CLINICAL MICROBIOLOGY AND INFECTION, 2020, 26 (11) :1537-1544

[43]

Yeung E., 2020, INT J ORAL MAX SURG, V49, P1385, DOI [10.1016/j.ijom.2020.08.007, DOI 10.1016/j.ijom.2020.08.007]

[44] Effect of Early vs Late Tracheostomy Placement on Survival in Patients Receiving Mechanical Ventilation The TracMan Randomized Trial [J].

Young, Duncan ;

Harrison, David A. ;

Cuthbertson, Brian H. ;

Rowan, Kathy .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 309 (20) :2121-2129

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