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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Head+Neck 2020 ; 42 (7): 1386-1391 Nephropedia Template TP
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Tracheotomy in COVID-19 patients: Optimizing patient selection and identifying prognostic indicators #MMPMID32441351
Head Neck 2020[Jul]; 42 (7): 1386-1391 PMID32441351show ga
BACKGROUND: Tracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity. METHODS: Prospective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined. RESULTS: Patients who sustained FiO(2) = 50% and PEEP = 8 cm H(2) O in the 24 hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48 hours. CONCLUSION: Sustained FiO(2) = 50% and PEEP = 8 cm H(2) O in the 48 hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity.
|*Length of Stay[MESH]
|Aged[MESH]
|COVID-19[MESH]
|Cohort Studies[MESH]
|Coronavirus Infections/*epidemiology[MESH]
|Female[MESH]
|Humans[MESH]
|Intensive Care Units/*statistics & numerical data[MESH]