Research Article


DOI :10.26650/Tr-ENT.2022.1131472   IUP :10.26650/Tr-ENT.2022.1131472    Full Text (PDF)

Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla

Šekib UmihanićSefika UmihanićDamir PištoljevićRahima JahićDževad DžananovićSamir Kamenjaković

Objective: The aim of the study was to present experience of performed tracheotomies during the Covid19 pandemic and to outline the adjustments made to the procedure for security reasons. Materials and Methods: In the retrospective study for the period March 2020 to April 2022 we analyzed the disease history data and surgical findings from all patients in UCC Tuzla who underwent surgical tracheotomy during the COVID-19 pandemic. Results: 52 patients who underwent open surgical tracheotomy after an invasive mechanical ventilation were analyzed in our study. Group A were 32 COVID-19 consecutive patients (22 male, mean age±13.54 years, range 23-76). The tracheotomy was performed approximately on day 12.4 of the intubation (range 4-28). Group B consisted of 22 patients who had not suffered from COVID-19, and their PCR test was negative for SARSCov-2 (12 male, mean age 59.4±20.40 years, range 19-87). The tracheotomy was performed approximately on day 10.1 of the intubation (range 2-20). There was a statistically significant difference in mortalities when both groups were compared. The most common complication was diffuse bleeding from soft tissue of the neck in the early post tracheotomy period and local infection in the later period. The most common comorbidities were arterial hypertension and diabetes mellitus. Conclusion: According to our study results, COVID-19 elderly patients who are on Invasive Mechanical Ventilation (IMV) have an uncertain prognosis. Correct timing of the tracheotomy is necessary so as not to further traumatize the patients.


PDF View

References

  • 1. Esteban A, Anzueto A, Alia I. How is mechanical ventilation employed in the intensive care unit: an international utilization review. Am J Respir Crit Care Med 2000;161(5):1450-8. google scholar
  • 2. He F, Deng Y, Li W. Coronavirus disease 2019 (COVID-19): what we know? J Med Virol 2020; 92(7):719-25. doi: 10.1002/jmv.25766. google scholar
  • 3. Mo P, Xing Y, Xiao Y, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis 2020;73(11):e4208-e4213. doi: 10.1093/cid/ ciaa270. google scholar
  • 4. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382(18):1708-20.doi: 10.1056/NEJMoa2002032. google scholar
  • 5. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506. google scholar
  • 6. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061-9. google scholar
  • 7. Smith D, Montagne J, Raices M, Dietrich A, Carboni Bisso I, Heras ML, et al. Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic. Am J Otolaryngol 2020;41(5):102578. doi: 10.1016/j.amjoto.2020.102578 google scholar
  • 8. Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology 2020;132(6):1317-32. google scholar
  • 9. Burn E, Sena AG, Prats-Uribe A, Spotnitz M, DuVall M, Lynch KE, et al. Use of dialysis, tracheostomy, and extracorporeal membrane oxygenation among 842,928 patients hospitalized with COVID-19 in the United States. medRxiv 2021:2020.11.25.20229088. doi: 10.1101/2020.11.25.20229088. google scholar
  • 10. Frauenfelder C, Butler C, Hartley B, Cochrane L, Jephson RN, Nash R. et al. Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic. Int J Pediatr Otorhinolaryngol March 2020;134:110030. doi: 10.1016/j.ijporl.2020.110030. google scholar
  • 11. Tay JK, Khoo ML, Loh WS. Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngol Head Neck Surg 2020;146(6):517-8. doi.org/ 10.1001/jamaoto.2020.0764. google scholar
  • 12. Francom CR, Javia L, Wolter NE, Soo Lee G, Wine T, Morrissey T, et al. Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: a four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes. Int J PediatrOtorhinolaryngol 2020;134:110059. doi: 10.1016/j.ijporl.2020.110059. google scholar
  • 13. Staibano P, Levin M, McHugh T, Gupta M, Sommer DD. Association of Tracheostomy with Outcomes in patients with COVID-19 and SARS-CoV-2 transmission among health care professionals: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2021;147(7):646-55. Doi: 10.1001/jamaoto.2021.0930. google scholar
  • 14. Sowerby LJ, Stephenson K, Dickie A, Lella FAD, Jefferson N, North H, et al. International registry of otolaryngologist-head and neck surgeons with COVID-19. Int Forum Allergy Rhinol 2020;10(11):1201-8. doi: 10.1 002/alr.22677. google scholar
  • 15. Benito DA, Bestourous DE, Tong JY, Pasick LJ, Sataloff RT. Tracheotomy in COVID-19 patients: a systematic review and meta-analysis of weaning, Decannulation, and survival. Otolaryngol Head Neck Surg 2021:165(3):398-405. doi: 10.1177/0194599820984780. google scholar
  • 16. Bjork V. Partial resection of the only remaining lung with the aid of respirator treatment. J Thorac Cardiovasc Surg 1960;39:179-88. google scholar
  • 17. Sifrer R, Benedik J, Anicin A. Elective open “Shield Tracheostomy” in patients with COVID-19. Eur Arch Otorhinolaryngol 2022;279(2):891-7. Doi: 10.1007/s00405-021-06820-7. google scholar
  • 18. McGrath B, Brenner MJ, Warrillow SJ, Pandian V, Arora A, Cameron TS, et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med 2020;8(7):717-25. google scholar
  • 19. Wood MH, Hailwood M, Koutelos K. Reducing the risk of oxygen-related fires and explosions in hospitals treating Covid-19 patients. Process Saf Environ Prot 2021;153:278-88. google scholar
  • 20. Liu CC, Livingstone D, Dixon E, Dort JC. Early versus late tracheostomy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2015;152(2):219-27. google scholar
  • 21. Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 2005;330 (7502):1243. google scholar
  • 22. Hosokawa K, Nishimura M, Egi M, Vincent JL. Timing of tracheotomy in ICU patients: a systematic review of randomized controlled trials. Crit Care 2015;19:424. google scholar
  • 23. Koshkareva Y, Gaughan JP, Soliman AM. Risk factors for adult laryngotracheal stenosis: a review of 74 cases. Ann Otol Rhinol Laryngol 2007;116(3):206-10. google scholar
  • 24. van Kampen JJ, van de Vijver DA, Fraaij PL, Haagmans BL, Lamers MM, Okba N, et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun 2021;12(1):267. https:// doi.org/10.1038/s41467-020-20568-4 google scholar
  • 25. Chao TN, Braslow BM, Martin ND, Ara AC, Atkins J, Haas AR, et al. Tracheotomy in ventilated patients with COVID-19. Ann Surg 2020;272(1):e30-2. 10.1097/SLA.0000000000003956 google scholar
  • 26. Staibano P, Levin M, McHugh T, Gupta M, Sommer DD. Association of Tracheostomy with Outcomes in patients with COVID-19 and SARS-CoV-2 transmission among health care professionals: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2021;147(7):646-55. google scholar
  • 27. Sowerby LJ, Stephenson K, Dickie A, Lella FAD, Jefferson N, North H, et al. International registry of otolaryngologist-head and neck surgeons with COVID-19. Int Forum Allergy Rhinol 2020;10(11):1201-8. google scholar
  • 28. Xu K, Zhang XH, Long XB, Lu X, Liu Z. An environmental study of tracheostomy on eight COVID-19 patients. J Otolaryngol Head Neck Surg 2021;50:3. doi: 10.1186/s40463-021-00494-1. google scholar
  • 29. Volo T, Stritoni P, Battel I, Zennaro B, Lazzari F, Bellin M, et al. Elective tracheostomy during COVID-19 outbreak: to whom, when, how? Early experience from Venice, Italy. Eur Arch Otorhnolaryngol 2021;278(3):781-9. doi: 10.1007/s00405-020-06190-6. google scholar
  • 30. Nam IC, Shin YS, Jeong WJ, Park MW, Park SY, Song CM, et al. Guidelines for Tracheostomy From the Korean Bronchoesophagological Society. Clin Exp Otorhinolaryngol 2020;13(4):361-75. google scholar
  • 31. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55(5):2000547. doi: 10.1183/13993003.00547-2020. google scholar
  • 32. Wenham C, Smith J, Morgan R, Gender and COVID-19 Working Group. COVID-19: the gendered impacts of the outbreak. Lancet 2020;395(10227):846-8. google scholar
  • 33. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41(2):145-51. doi: 10.3760/cma.j.is sn.0254-6450.2020.02.003. google scholar
  • 34. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the lombardy region, Italy. JAMA 2020;323(16):1574-81. google scholar
  • 35. Johnson-Obaseki S, Veljkovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients. Laryngoscope 2016;126(11):2459-67. google scholar
  • 36. Oliver ER, Gist A, Gillespie MB. Percutaneous versus surgical tracheotomy: an updated meta-analysis. Laryngoscope 2007;117(9):1570-5. google scholar
  • 37. Simon M, Metschke M, Braune SA, Püschel K, Kluge S. Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors. Crit Care 2013;17(5):R258. google scholar
  • 38. Halum SL, Ting JY, Plowman EK, Belafsky PC, Harbarger CF, Postma GN, et al. A multi-institutional analysis of tracheotomy complications. Laryngoscope 2012;122(1):38-45. google scholar
  • 39. Ülkümen B, Eskiizmir G, Tok D, Çivi M, Çelik O. Our Experience with percutaneous and surgical tracheotomy in intubated critically ill patients. Turk Arch Otorhinolaryngol 2018;56:199-205. google scholar
  • 40. Jotic AD, Milovanovic JP, Trivic AS, Folic MM, Krejovic-Trivic SB, Radin ZZ, et al. Predictors of Complications Occurrence Associated With Emergency Surgical Tracheotomy. Otolaryngol Head Neck Surg 2021;164(2):346-52. google scholar
  • 41. Botti C, Lusetti F, Neri T, Peroni S. Castellucci A, Salsi P, et al. Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits Auris Nasus Larynx 2021;48(3):511-7. google scholar
  • 42. Anderson JD, Rabinovici R, Frankel HL. Percutaneous dilational tracheostomy vs open tracheostomy. Chest 2001;120(4):1423-4. google scholar
  • 43. Heffner JE. Percutaneous dilatational vs standard tracheotomy: a meta-analysis but not the final analysis. Chest 2000;118(5):1236-8. google scholar
  • 44. Susanto I. Comparing percutaneous tracheostomy with open surgical tracheostomy. BMJ 2002;324(7328):3-4. google scholar
  • 45. Philip A Weissbrod, Albert L Merati. Is percutaneous dilational tracheotomy equivalent to traditional open surgical tracheotomy with regard to perioperative and postoperative complications? Laryngoscope 2012;122(7):1423-4. doi: 10.1002/lary.23289. google scholar
  • 46. Fang X, Li S, Yu H, Wang P, Zhang Y, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY) 2020;12(13):12493-503. google scholar
  • 47. Perez FM, del Pino JL, Garcıa NJ, Ruiz EM, Mendez CA, Jimenez JMG, et al. Comorbidity and prognostic factors on admission in a COVID-19 cohort of a general hospital. Rev Clin Esp (Barc) 2021;221(9):529-35. google scholar
  • 48. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020;36(7):e3319. doi: 10.1002/dmrr.3319. google scholar
  • 49. Ushigome E, Hamaguchi M, Sudo K, Kitagawa N, Kondo Y, Imai D, et al. Impact of untreated diabetes and COVID-19-related diabetes on severe COVID-19. Heliyon 2022;8(1):e08801. doi: 10.1016/j. heliyon.2022.e08801. google scholar
  • 50. Chowdhary A, Tarai B, Singh A, Sharma A. Multidrug-resistant Candida auris infections in critically ill coronavirus disease patients, India, AprilJuly 2020. Emerg Infect Dis 2020;26(11):2694-6. google scholar
  • 51. Patel D, Devulapally K, Islam S. Safety of percutaneous tracheostomy in patients with coagulopathy and high ventilatory demand. Chest 2009;136(4):50S. doi: 10.1016/S0012-3692(16)48047-5 google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format


EXPORT



APA

Umihanić, Š., Umihanić, S., Pištoljević, D., Jahić, R., Džananović, D., & Kamenjaković, S. (2022). Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla. The Turkish Journal of Ear Nose and Throat, 32(3), 51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472


AMA

Umihanić Š, Umihanić S, Pištoljević D, Jahić R, Džananović D, Kamenjaković S. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla. The Turkish Journal of Ear Nose and Throat. 2022;32(3):51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472


ABNT

Umihanić, Š.; Umihanić, S.; Pištoljević, D.; Jahić, R.; Džananović, D.; Kamenjaković, S. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla. The Turkish Journal of Ear Nose and Throat, [Publisher Location], v. 32, n. 3, p. 51-57, 2022.


Chicago: Author-Date Style

Umihanić, Šekib, and Sefika Umihanić and Damir Pištoljević and Rahima Jahić and Dževad Džananović and Samir Kamenjaković. 2022. “Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla.” The Turkish Journal of Ear Nose and Throat 32, no. 3: 51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472


Chicago: Humanities Style

Umihanić, Šekib, and Sefika Umihanić and Damir Pištoljević and Rahima Jahić and Dževad Džananović and Samir Kamenjaković. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla.” The Turkish Journal of Ear Nose and Throat 32, no. 3 (Oct. 2022): 51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472


Harvard: Australian Style

Umihanić, Š & Umihanić, S & Pištoljević, D & Jahić, R & Džananović, D & Kamenjaković, S 2022, 'Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla', The Turkish Journal of Ear Nose and Throat, vol. 32, no. 3, pp. 51-57, viewed 2 Oct. 2022, https://doi.org/10.26650/Tr-ENT.2022.1131472


Harvard: Author-Date Style

Umihanić, Š. and Umihanić, S. and Pištoljević, D. and Jahić, R. and Džananović, D. and Kamenjaković, S. (2022) ‘Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla’, The Turkish Journal of Ear Nose and Throat, 32(3), pp. 51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472 (2 Oct. 2022).


MLA

Umihanić, Šekib, and Sefika Umihanić and Damir Pištoljević and Rahima Jahić and Dževad Džananović and Samir Kamenjaković. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla.” The Turkish Journal of Ear Nose and Throat, vol. 32, no. 3, 2022, pp. 51-57. [Database Container], https://doi.org/10.26650/Tr-ENT.2022.1131472


Vancouver

Umihanić Š, Umihanić S, Pištoljević D, Jahić R, Džananović D, Kamenjaković S. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla. The Turkish Journal of Ear Nose and Throat [Internet]. 2 Oct. 2022 [cited 2 Oct. 2022];32(3):51-57. Available from: https://doi.org/10.26650/Tr-ENT.2022.1131472 doi: 10.26650/Tr-ENT.2022.1131472


ISNAD

Umihanić, Šekib - Umihanić, Sefika - Pištoljević, Damir - Jahić, Rahima - Džananović, Dževad - Kamenjaković, Samir. Tracheotomy During Pandemic COVID-19 Outbreak. Experience At University Clinical Center Tuzla”. The Turkish Journal of Ear Nose and Throat 32/3 (Oct. 2022): 51-57. https://doi.org/10.26650/Tr-ENT.2022.1131472



TIMELINE


Submitted16.06.2022
Accepted20.07.2022

LICENCE


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.