COVID-19 환자의 변형된 경피적 기관절개술의 특성 분석: 1년간의 단일 기관 경험
Characteristics of Hybrid Modified Percutaneous Dilatational Tracheostomy in Patients With COVID-19: A Single Institutional Experience Over 1 Year
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives Coronavirus disease 2019 (COVID-19) is a worldwide pandemic,and some patients require mechanical ventilation and tracheostomy. Owing to the risksof aerosol spreading to health care workers, the protocols and guidelines related to the noveltiming and technique for tracheostomy are rapidly changing. We investigated the characteristicsof tracheostomy with patients with COVID-19 over a year. Subjects and Method We measured the mean time from intubation to the tracheostomy,survival rate, the incidence of infection to medical staff, and operation time, complications fortracheostomy, and the time of decannulation. All patients underwent a novel percutaneous tracheostomywithout bronchoscope (hybrid modified percutaneous dilatational tracheostomy,hybrid MPDT) in the negative pressure intensive care unit. Results Of the 448 patients with COVID-19 patients, 34 required invasive mechanical ventilationat a tertiary hospital from February 2020 to April 2021. Of those, 15 patients underwenttracheostomy. Of the tracheostomy patients, survival rate was 93.33%. The mean timefrom intubation to the tracheostomy was 18.27±14.74 days (range, 8-36 days). The incidenceof infection to medical staff was zero percent whereas racheostomy-related bleeding was themost common complication (2 patients). Operation time for hybrid MPDT was 5.45±1.12 min. Conclusion The optimal timing of tracheostomy procedure for COVID-19 patients is stillunknown, but it is believed that the treatment of COVID-19 can be achieved better if the hybridMPDT is used at the right time
Abstract
Background and Objectives Coronavirus disease 2019 (COVID-19) is a worldwide pandemic,and some patients require mechanical ventilation and tracheostomy. Owing to the risksof aerosol spreading to health care workers, the protocols and guidelines related to the noveltiming and technique for tracheostomy are rapidly changing. We investigated the characteristicsof tracheostomy with patients with COVID-19 over a year. Subjects and Method We measured the mean time from intubation to the tracheostomy,survival rate, the incidence of infection to medical staff, and operation time, complications fortracheostomy, and the time of decannulation. All patients underwent a novel percutaneous tracheostomywithout bronchoscope (hybrid modified percutaneous dilatational tracheostomy,hybrid MPDT) in the negative pressure intensive care unit. Results Of the 448 patients with COVID-19 patients, 34 required invasive mechanical ventilationat a tertiary hospital from February 2020 to April 2021. Of those, 15 patients underwenttracheostomy. Of the tracheostomy patients, survival rate was 93.33%. The mean timefrom intubation to the tracheostomy was 18.27±14.74 days (range, 8-36 days). The incidenceof infection to medical staff was zero percent whereas racheostomy-related bleeding was themost common complication (2 patients). Operation time for hybrid MPDT was 5.45±1.12 min. Conclusion The optimal timing of tracheostomy procedure for COVID-19 patients is stillunknown, but it is believed that the treatment of COVID-19 can be achieved better if the hybridMPDT is used at the right time
참고문헌 (23)
- 김준곤, "코로나바이러스감염증-19에서의 후각장애", 대한이비인후-두경부외과학회지, 63(11), pp.491~496 (2020), 대한이비인후과학회[DOI]
- 위승범, "코로나19 중환자의 치료", 대한내과학회지, 96(1), pp.22~29 (2021), 대한내과학회[DOI]
- Bier-Laning C, "Tracheostomy during the COVID-19 pandemic : Comparison of international perioperative care protocols and practices in 26countries", Otolaryngol Head Neck Surg, 164(6), pp.1136~1147 (2021)
- Chiesa-Estomba CM, "Systematic review of international guidelines for tracheostomy in COVID-19 patients", Oral Oncol, 108, pp.104844~ (2020)
- Heyd CP, "Tracheostomy protocols during COVID-19 pandemic", Head Neck, 42(6), pp.1297~1302 (2020)
- Kligerman MP, "Managing head and neck cancer patients with tracheostomy or laryngectomy during the COVID-19 pandemic", Head Neck, 42(6), pp.1209~1213 (2020)
- Lamb CR, "Use of tracheostomy during the COVID-19 pandemic : American College of Chest Physicians", American Association for Bronchology and Interventional Pulmonology, Chest, pp.2020, 158(4)[DOI]
- McGrath BA, "Tracheostomy in the COVID-19 era : Global and multidisciplinary guidance", Lancet Respir Med, 8(7), pp.717~725 (2020)
- Michetti CP, "Performing tracheostomy during the Covid-19 pandemic : Guidance and recommendations from the Critical Care and Acute Care Surgery Committees of the American Association for the Surgery of Trauma", Trauma Surg Acute Care Open, 5(1), pp.e000482~ (2020)
- "Tracheotomy recommendations during the COVID-19pandemic" (2020)[URL]
- Swain SK, "Performing tracheostomy in intensive care unit-A challenge during COVID-19 pandemic", Siriraj Med J, 72(5), pp.436~442 (2020)
- Vargas M, "Modified percutaneous tracheostomy in COVID-19 critically ill patients", Head Neck, 42(7), pp.1363~1366 (2020)
- 김성균, "기관절개용 튜브 제거술 후 상처 회복에 영향을 미치는 요소", Annals of Rehabilitation Medicine, 34(4), pp.432~435 (2010), 대한재활의학회
- Yang X, "Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study", Lancet Respir Med, 8(5), pp.475~481 (2020)
- Kwak PE, "Early outcomes from early tracheostomy for patients with COVID-19", JAMA Otolaryngol Head Neck Surg, 147(3), pp.239~244 (2021)
- Angel L, "Novel percutaneous tracheostomy for critically ill patients with COVID-19", Ann Thorac Surg, 110(3), pp.1006~1011 (2020)
- Martin-Villares C, "Outcome of 1890 tracheostomies for critical COVID-19 patients : A national cohort study in Spain", Eur Arch Otorhinolaryngol, 278(5), pp.1605~1612 (2021)
- Breik O, "Safety and 30-day outcomes of tracheostomy for COVID-19 : A prospective observational cohort study", Br J Anaesth, 125(6), pp.872~879 (2020)
- Piazza C, "Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses : A call to action from the European Laryngological Society", Eur Arch Otorhinolaryngol, 278(1), pp.1~7 (2021)
- Schuler PJ, "Surgical tracheostomy in a cohort of COVID-19 patients", HNO, 69(4), pp.303~311 (2021)
- 신현일, "중환자실 환자에서 관혈적 기관 절개술과 경피적 확장 기관 절개술의 비교", 대한이비인후-두경부외과학회지, 62(5), pp.288~293 (2019), 대한이비인후과학회[DOI]
- Cho YJ, "Severe complication of percutaneous dilatational tracheostomy", J Korean Soc Laryngol Phoniatr Logop, 27(1), pp.54~57 (2016)
- Takhar A, "Recommendation of a practical guideline for safe tracheostomy during the COVID-19 pandemic", Eur Arch Otorhinolaryngol, 277(8), pp.2173~2184 (2020)