• Hussam Elmelliti, Dnyaneshwar Pandurang Mutkule, Muhammad Imran, Nabil Abdelhamid Shallik, Ali Ait Hssain, and Ahmed Labib Shehatta.
• Emergency Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: HElmelliti@hamad.qa.
• J. Cardiothorac. Vasc. Anesth. 2023 Jan 1; 37 (1): 738073-80.

ObjectivesTracheostomy usually is performed to aid weaning from mechanical ventilation and facilitate rehabilitation and secretion clearance. Little is known about the safety of percutaneous tracheostomy in patients with severe COVID-19 supported on venovenous extracorporeal membrane oxygenation (VV-ECMO). This study aimed to investigate the bleeding risk of bedside percutaneous tracheostomy in patients with COVID-19 infection supported with VV-ECMO.DesignA Retrospective review of electronic data for routine care of patients on ECMO.SettingTertiary, university-affiliated national ECMO center.ParticipantsPatients with COVID-19 who underwent percutaneous tracheostomy while on VV-ECMO support.InterventionsNo intervention was conducted during this study.Measurements And Main ResultsElectronic medical records of 16 confirmed patients with COVID-19 who underwent percutaneous tracheostomy while on VV-ECMO support, including patient demographics, severity of illness, clinical variables, procedural complications, and outcomes, were compared with 16 non-COVID-19 patients. The SPSS statistical software was used for statistical analysis. The demographic data were compared using the chi-square test, and normality assumption was tested using the Shapiro-Wilk test. The indications for tracheostomy in all the patients were prolonged mechanical ventilation and sedation management. None of the patients suffered a life-threatening procedural complication within 48 hours. Moderate-to-severe bleeding was similar in both groups. There was no difference in 30- and 90-days mortality between both groups. As per routine screening results, none of the staff involved contracted COVID-19 infection.ConclusionsIn this case series, percutaneous tracheostomy during VV-ECMO in patients with COVID-19 appeared to be safe and did not pose additional risks to patients or healthcare workers.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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