The surgical airway in the COVID-19 era

Monica C. Azmy, Shravani Pathak, Bradley A. Schiff

Research output: Contribution to journalArticlepeer-review

Abstract

The aim is to summarize the guidelines for tracheostomy management during the COVID-19 pandemic. This is a comparative study analysis and literature review using articles found in the PubMed/MEDLINE database. Here we summarize published work on tracheostomy timing, technique, outcomes, mortality, and decannulation rates during the COVID-19 pandemic, with a focus on expertise from our own institution. Among 12 studies, 2,692 tracheostomies were performed at an average of 17.5 days from intubation. 66.4% were performed open, and 33.6% percutaneously. A total of 85.6% were performed bedside, and 14.4% in the operating room. 19.5% experienced all-cause mortality, and 43.4% were decannulated. In these studies, only 1 proceduralist became infected with COVID-19. Early COVID-19 recommendations advocated for tracheostomy a minimum of 14 days from intubation. Currently, tracheostomy is performed more closely to prepandemic criteria. Bedside tracheostomy comprised most procedures during the pandemic. Tracheostomy in COVID-19 patients, when performed with techniques to minimize aerosolization, is safe and poses minimal risk of infection to providers performing the procedure.

Original languageEnglish (US)
JournalOperative Techniques in Otolaryngology - Head and Neck Surgery
DOIs
StateAccepted/In press - 2022

Keywords

  • COVID-19
  • Surgical airway
  • Tracheostomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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