• Thomas J Stubington, Ali S Mallick, Georgios Garas, Emma Stubington, Chetan Reddy, and Mohammed S Mansuri.
• Department of Otorhinolaryngology-Head and Neck Surgery, Royal Derby Hospital, Derby, UK.
• Head Neck. 2020 Jul 1; 42 (7): 1386-1391.

BackgroundTracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity.MethodsProspective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined.ResultsPatients who sustained FiO2  ≤ 50% and PEEP ≤ 8 cm H2 O in the 24 hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48 hours.ConclusionSustained FiO2  ≤ 50% and PEEP ≤ 8 cm H2 O in the 48 hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity.© 2020 Wiley Periodicals, Inc.

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