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Indian J Crit Care Med · Sep 2020
Percutaneous Tracheostomy in COVID-19 Patients: A Four-step Safe Protocol.
- Prashant Nasa, Aanchal Singh, Alaeldin Ali, Saroj Patidar, and Annamma Georgian.
- Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, United Arab Emirates.
- Indian J Crit Care Med. 2020 Sep 1; 24 (9): 832-834.
BackgroundCoronavirus disease-2019 (COVID-19) pandemic has inundated healthcare systems globally especially resources in intensive care units (ICUs). Tracheostomy may be required in critically ill COVID-19 patients to facilitate weaning and to optimize resources like ventilator and ICU beds. Percutaneous tracheostomy (PCT) has become the standard of care globally in ICUs; however, it is considered a high-risk procedure in COVID-19 patients because of the inherent risk of aerosol generation.Materials And MethodsPatients with severe COVID-19 who were on mechanical ventilation because of respiratory failure for ≥10 days were evaluated for PCT. We developed a four-step approach from patient selection and timing, preparation, performance, and postprocedure for PCT in these patients.ResultsWe evaluated our four-step protocol in four patients. One of them was non-COVID patient and rest three were COVID patients. The procedure was uneventful in all of the patients with median time of procedure and apnea is 10 minutes 30 seconds and 2 minutes 20 seconds, respectively. The tracheostomy was decannulated in two of these patients and one patient is still on ventilator.ConclusionWe believe our four-step protocol for PCT in critically ill COVID-19 patient is simple, safe, and easily adapted in any setting with limited training and available resources. We recommend further studies to evaluate this approach in selected critically ill COVID-19 patients who need tracheostomy.How To Cite This ArticleNasa P, Singh A, Ali A, Patidar S, Georgian A. Percutaneous Tracheostomy in COVID-19 Patients: A Four-step Safe Protocol. Indian J Crit Care Med 2020;24(9):832-834.Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.
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