A safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19: A quality improvement study.
Abstract | Importance: Objective: This study aimed to propose a safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19. Design: This is a single center quality improvement study. Participants:
Tracheotomy is a necessary and important step in airway management for COVID-19 patients with prolonged endotracheal intubation, IMV, failed extubation, and ventilator dependence. Standardized third-level protection measures and bulky personal protective equipment (PPE) may hugely impede the implementation of tracheotomy, especially when determining the optimal pre-surgical positioning for COVID-19 patients with ambiguous surface position, obesity, short neck or limited neck extension, due to vision impairment, reduced tactile sensation and motility associated with PPE. Consequently, the aim of this study was to propose a safer and more practical tracheotomy, namely percutaneous dilated tracheotomy ( PDT) with delayed endotracheal intubation withdrawal under the guidance of bedside ultrasonography without the conventional use of flexible fiberoptic bronchoscopy (FFB), which can accurately determine the optimal pre-surgical positioning, as well as avoid intraoperative damage of the posterior tracheal wall and prevent the occurrence of tracheoesophageal fistula (TEF).
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Authors | Kai Kang, Junfeng Wang, Xue Du, Nana Li, Songgen Jin, Yuanyuan Ji, Xinjia Liu, Pengfei Chen, Chuangshi Yue, Jihan Wu, Xintong Wang, Yujia Tang, Qiqi Lai, Baitao Lu, Yang Gao, Kaijiang Yu |
Journal | Frontiers in surgery
(Front Surg)
Vol. 9
Pg. 1018637
( 2022)
ISSN: 2296-875X [Print] Switzerland |
PMID | 36386537
(Publication Type: Journal Article)
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Copyright | © 2022 Kang, Wang, Du, Li, Jin, Ji, Liu, Chen, Yue, Wu, Wang, Tang, Lai, Lu, Gao and Yu. |
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