TY - JOUR
T1 - Tracheostomy in the COVID-19 era: global and multidisciplinary guidance
AU - McGrath, Brendan A.
AU - Brenner, Michael J.
AU - Warrillow, Stephen J.
AU - Pandian, Vinciya
AU - Arora, Asit
AU - Cameron, Tanis S.
AU - Anon, Jose Manuel
AU - Martinez, Gonzalo Hernandez
AU - Truog, Robert D.
AU - Block, Susan D.
AU - Lui, Grace C. Y.
AU - McDonald, Christine
AU - Rassekh, Christopher H.
AU - Atkins, Joshua
AU - Qiang, Li
AU - Vergez, Sebastien
AU - Dulguerov, Pavel
AU - Zenk, Johannes
AU - Antonelli, Massimo
AU - Pelosi, Paolo
AU - Walsh, Brian K.
AU - Ward, Erin
AU - Shang, You
AU - Gasparini, Stefano
AU - Donati, Abele
AU - Singer, Mervyn
AU - Openshaw, Peter J. M.
AU - Tolley, Neil
AU - Markel, Howard
AU - Feller-Kopman, David J.
N1 - Funding Information:
VP is a consultant for Medtronic. CHR and DJF-K report unrestricted grants from Cook Medical supporting medical education; CHR reports a patent pending for an intubation protective tent and method of use and disinfecting (US patent application number 63/000,106, filed March 26, 2020, and application number 63/012,746, filed April 20, 2020; patent licensee, trustees of the University of Pennsylvania). JA reports a grant from Becton-Dickinson, outside the submitted work. JZ reports consultancy fees from Karl Storz and Zeiss, outside the submitted work. MA reports grants from GE and Intersurgical, and personal fees from Orion and Intersurgical, outside the submitted work. MS reports a grant from NewB and fees to his institution from Merck Sharp & Dohme, Amormed, and Biotest, outside the submitted work. All other authors declare no competing interests.
Publisher Copyright:
© 2020 Elsevier Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.
AB - Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.
KW - Betacoronavirus
KW - COVID-19
KW - Coronavirus Infections/prevention & control
KW - Critical Care/methods
KW - Humans
KW - Infectious Disease Transmission, Patient-to-Professional/prevention & control
KW - Internationality
KW - Pandemics/prevention & control
KW - Pneumonia, Viral/prevention & control
KW - Practice Guidelines as Topic
KW - SARS-CoV-2
KW - Tracheostomy/methods
U2 - 10.1016/S2213-2600(20)30230-7
DO - 10.1016/S2213-2600(20)30230-7
M3 - Review article
C2 - 32422180
SN - 2213-2600
VL - 8
SP - 717
EP - 725
JO - The Lancet Respiratory Medicine
JF - The Lancet Respiratory Medicine
IS - 7
ER -
