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Title: Tracheostomy in COVID-19 Pandemic; did we achieve our aims? A developing country's experience.
Authors: Hadia Wali, Abdus Saboor, Shayan Shahid Ansari, Tafiya Erum Kamran, Muhammad Saqib, Muhammad Inam Ul Haq
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 10
Language: English
DOI: 10.29309/TPMJ/2023.30.10.7654
Keywords: COVID-19PneumoniaTracheostomyVentilatorWean Off
Objective: To evaluate the effect of tracheostomy on COVID positive patients and the risk included in the procedure for the patient and health care workers. Study Design: Retrospective Observational Study. Setting: Shifa International Hospital Islamabad, Pakistan. Period: 30th May 2020 to 15th February 2022. Material & Methods: The tracheostomies were performed in COVID ICU at bed side by ENT team. This is a study of 22 patients mostly with multiple comorbidities who presented to the hospital with symptoms of SARS-COVID-19. The changes in their ventilation were recorded before and after the tracheostomy. The health care workers included in the study were also kept under observation for any possible cross infection. Results: Eight out of twenty two patients were weaned off from ventilator. There was decrease in partial pressure of oxygen after the procedure but the mortality rate was high. None of the members of operating team, ICU team, anaesthesia team was infected with the virus. Conclusion: Our study shows that although tracheostomy helps in weaning off from ventilator, it has no role in weaning off COVID patients. There is no benefit of tracheostomy for a COVID positive patients. Furthermore, if adequate personal protective equipment’s are used, there is no risk of spread of infection from patient during the procedure of tracheostomy.
To evaluate the effect of tracheostomy on COVID-19 positive patients and the associated risks for patients and healthcare workers.
Retrospective observational study conducted at Shifa International Hospital, Islamabad, Pakistan, from May 30, 2020, to February 15, 2022. The study involved 22 COVID-19 patients who underwent bedside tracheostomy by an ENT team. Data on ventilation changes before and after the procedure were recorded, and healthcare workers were monitored for cross-infection.
graph TD;
A["Identify COVID-19 patients requiring ventilatory support"] --> B["Perform Retrospective Data Collection"];
B --> C["Analyze Ventilation Changes Before and After Tracheostomy"];
B --> D["Monitor Healthcare Worker Infections"];
C --> E["Evaluate Tracheostomy Effectiveness for Weaning"];
D --> F["Assess Risk of Cross-Infection"];
E --> G["Draw Conclusions on Tracheostomy's Role"];
F --> G;
Tracheostomy in COVID-19 patients did not appear to aid in weaning from ventilators. The study suggests that with adequate personal protective equipment (PPE), the risk of infection spread from patients to healthcare workers during tracheostomy procedures is minimal. The high mortality rate is attributed to factors like comorbidities and complications during hospitalization.
Eight out of twenty-two patients were weaned off the ventilator. There was a decrease in partial pressure of oxygen after the procedure, but the mortality rate was high (64%). No members of the operating, ICU, or anesthesia teams were infected with the virus.
Tracheostomy does not help in weaning COVID-19 patients from ventilators. Adequate use of PPE minimizes the risk of infection spread to healthcare workers during the procedure.
- The study included 22 patients.
- The study period was from May 30, 2020, to February 15, 2022.
- The mortality rate in the study was 64%.
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