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10.1016/j.jss.2020.10.013 http://scihub22266oqcxt.onion/10.1016/j.jss.2020.10.013 33316758!7587136!33316758     free     free     free Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Surg+Res 2021 ; 260 (ä): 38-45 Nephropedia Template TP {{tp|p=33316758|t=2021. Short-term Outcomes for Patients and Providers After Elective Tracheostomy in COVID-19-Positive Patients |pdf=|usr=}}{{33316758}} gab.com Text Short-term Outcomes for Patients and Providers After Elective Tracheostomy in COVID-19-Positive Patients JO: J Surg Res http://www.kidney.de/pget.php?&tw=1&pmid=33316758 #FOAvip BACKGROUND: Urgent guidance is needed on the safety for providers of percutaneous tracheostomy in patients diagnosed with COVID-19. The objective of the study was to demonstrate that percutaneous dilational tracheostomy (PDT) with a period of apnea in patients requiring prolonged mechanical ventilation due to COVID-19 is safe and can be performed for the usual indications in the intensive care unit. METHODS: This study involves an observational case series at a single-center medical intensive care unit at a level-1 trauma center in patients diagnosed with COVID-19 who were assessed for tracheostomy. Success of a modified technique included direct visualization of tracheal access by bronchoscopy and a blind dilation and tracheostomy insertion during a period of patient apnea to reduce aerosolization. Secondary outcomes include transmission rate of COVID-19 to providers and patient complications. RESULTS: From April 6th, 2020 to July 21st, 2020, 2030 patients were admitted to the hospital with COVID-19, 615 required intensive care unit care (30.3%), and 254 patients required mechanical ventilation (12.5%). The mortality rate for patients requiring mechanical ventilation was 29%. Eighteen patients were assessed for PDT, and 11 (61%) underwent the procedure. The majority had failed extubation at least once (72.7%), and the median duration of intubation before tracheostomy was 15 d (interquartile range 13-24). The median positive end-expiratory pressure at time of tracheostomy was 10.8. The median partial pressure of oxygen (PaO2)/FiO2 ratio on the day of tracheostomy was 142.8 (interquartile range 104.5-224.4). Two patients had bleeding complications. At 1-week follow-up, eight patients still required ventilator support (73%). At the most recent follow-up, eight patients (73%) have been liberated from the ventilator, one patient (9%) died as a result of respiratory/multiorgan failure, and two were discharged on the ventilator (18%). Average follow-up was 20 d. None of the surgeons performing PDT have symptoms of or have tested positive for COVID-19. CONCLUSIONS: and relevance: PDT for patients with COVID-19 is safe for health care workers and patients despite higher positive end-expiratory pressure requirements and should be performed for the same indications as other causes of respiratory failure. Twit Text FOAVip Short-term Outcomes for Patients and Providers After Elective Tracheostomy in COVID-19-Positive Patients ????J Surg Res http://www.kidney.de/pget.php?&tw=1&pmid=33316758 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33316758 #FOAvip English Wikipedia <ref>{{Cite pmid|33316758}}</ref> Short-term Outcomes for Patients and Providers After Elective Tracheostomy in COVID-19-Positive Patients #MMPMID33316758 Murphy P; Holler E; Lindroth H; Laughlin M; Simons CJ; Streib EW; Boustani M; Ortiz D J Surg Res 2021[Apr]; 260 (ä): 38-45 PMID33316758show ga BACKGROUND: Urgent guidance is needed on the safety for providers of percutaneous tracheostomy in patients diagnosed with COVID-19. The objective of the study was to demonstrate that percutaneous dilational tracheostomy (PDT) with a period of apnea in patients requiring prolonged mechanical ventilation due to COVID-19 is safe and can be performed for the usual indications in the intensive care unit. METHODS: This study involves an observational case series at a single-center medical intensive care unit at a level-1 trauma center in patients diagnosed with COVID-19 who were assessed for tracheostomy. Success of a modified technique included direct visualization of tracheal access by bronchoscopy and a blind dilation and tracheostomy insertion during a period of patient apnea to reduce aerosolization. Secondary outcomes include transmission rate of COVID-19 to providers and patient complications. RESULTS: From April 6th, 2020 to July 21st, 2020, 2030 patients were admitted to the hospital with COVID-19, 615 required intensive care unit care (30.3%), and 254 patients required mechanical ventilation (12.5%). The mortality rate for patients requiring mechanical ventilation was 29%. Eighteen patients were assessed for PDT, and 11 (61%) underwent the procedure. The majority had failed extubation at least once (72.7%), and the median duration of intubation before tracheostomy was 15 d (interquartile range 13-24). The median positive end-expiratory pressure at time of tracheostomy was 10.8. The median partial pressure of oxygen (PaO2)/FiO2 ratio on the day of tracheostomy was 142.8 (interquartile range 104.5-224.4). Two patients had bleeding complications. At 1-week follow-up, eight patients still required ventilator support (73%). At the most recent follow-up, eight patients (73%) have been liberated from the ventilator, one patient (9%) died as a result of respiratory/multiorgan failure, and two were discharged on the ventilator (18%). Average follow-up was 20 d. None of the surgeons performing PDT have symptoms of or have tested positive for COVID-19. CONCLUSIONS: and relevance: PDT for patients with COVID-19 is safe for health care workers and patients despite higher positive end-expiratory pressure requirements and should be performed for the same indications as other causes of respiratory failure. |Adult[MESH] |Aged[MESH] |Airway Extubation/statistics & numerical data[MESH] |Bronchoscopy/*adverse effects/instrumentation/methods/standards[MESH] |COVID-19 Nucleic Acid Testing/statistics & numerical data[MESH] |COVID-19/diagnosis/mortality/*therapy/transmission[MESH] |Female[MESH] |Follow-Up Studies[MESH] |Hospital Mortality[MESH] |Humans[MESH] |Infectious Disease Transmission, Patient-to-Professional/*prevention & control/statistics & numerical data[MESH] |Intensive Care Units/standards/statistics & numerical data[MESH] |Male[MESH] |Middle Aged[MESH] |Postoperative Complications/*epidemiology/etiology[MESH] |Respiration, Artificial/*adverse effects/instrumentation/methods/statistics & numerical data[MESH] |Retrospective Studies[MESH] |SARS-CoV-2/isolation & purification[MESH] |Severity of Illness Index[MESH] |Time Factors[MESH] |Tracheostomy/*adverse effects/instrumentation/methods/standards[MESH]Short-term Outcomes for Patients and Providers After Elective Tracheos(epmc).pdf DeepDyve Pubget Overpricing