Tracheostomy in the COVID-19 era: global and multidisciplinary guidance

Massimo Antonelli, Brendan A Mcgrath, Michael J Brenner, Stephen J Warrillow, Vinciya Pandian, Asit Arora, Tanis S Cameron, José Manuel Añon, Gonzalo Hernández Martínez, Robert D Truog, Susan D Block, Grace C Y Lui, Christine Mcdonald, Christopher H Rassekh, Joshua Atkins, Li Qiang, Sébastien Vergez, Pavel Dulguerov, Johannes Zenk, Paolo PelosiBrian K Walsh, Erin Ward, You Shang, Stefano Gasparini, Abele Donati, Mervyn Singer, Peter J M Openshaw, Neil Tolley, Howard Markel, David J Feller-Kopman

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.
Original languageEnglish
Pages (from-to)717-725
Number of pages9
JournalTHE LANCET. RESPIRATORY MEDICINE
Volume2020
DOIs
Publication statusPublished - 2020

Keywords

  • Tracheostomy

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