A Percutaneous Tracheostomy Experience in The ICU During The COVID-19 Pandemic

Abstract

Aim: During the COVID-19 pandemic, some procedural changes for the percutaneous tracheostomy (PT) procedure were necessary to prevent virus transmission to the operators. In this prospective study, it was investigated whether there were clinical differences in COVID-19 and non-COVID-19 patient groups who needed PT. Study design: All patients who were greater than 18 years, who underwent PT in the tertiary COVID-19 and Internal Medicine ICU between January 2020 and January 2022 were included. Demographic and laboratory informations, pre– and post PT chest X-rays, and other clinical data during ICU follow-up were collected. Materials and methods: All necessary protective equipment was used by the PT team for the COVID-19 patients. Required sedoanalgesia and neuromuscular muscle blockade were applied. PT was performed by applying the forceps dilatation method defined by Griggs. Results: A total of 40 patients were included, 19 (47%) of them were female, median age was 78 [67–83] years. APACHE II score and SOFA score of the patients were 19.5 [17.0–22.7] and 7.5 [6.0–9.0]. Mortality rate was 16 (40%) and was not different between groups (p=0.289). Percutaneous tracheostomy procedure time was 8 [5–10] minute and did not differ between groups (p=0.865). A total of 4 (10%) VAP (ventilator-associated pneumonia), 2 (5%) sepsis, and 4 (10%) local hemorrhage developed after PT procedure. The length of ICU stay after the PT procedure was 11 [5–30] days and not statistically significant (p=0.066). Conclusion: PT can be safely applied in COVID-19 patients with similar mortality and complication rates as non-COVID-19 patients.