Percutaneous and open tracheostomy in patients with COVID‐19: The Weill Cornell experience in New York City

xlomafota13 shared this article with you from Inoreader Percutaneous and open tracheostomy in patients with COVID‐19: The Weill Cornell experience in New York City Via The Laryngoscope Abstract Objective Report long-term tracheostomy outcomes in patients with COVID-19. Methods Prospectively collected data were extracted for adults with COVID-19 undergoing percutaneous or open tracheostomy between April 4 and June 2, 2020 at a major medical center in New York City. The primary endpoint was weaning from mechanical ventilation. Secondary outcomes included sedation weaning, decannulation, and discharge. Results 101 patients underwent tracheostomy, including 48 percutaneous (48%) and 53 open (52%), after a median intubation time of 24 days (IQR 20, 31). The most common complication was minor bleeding (n = 18, 18%). The all-cause mortality rate was 15% and no deaths were attributable to the tracheostomy. Eighty-three patients (82%) were weaned off mechanical ventilation, 88 patients (87%) were weaned off sedation, and 72 patients (71%) were decannulated. Censored median times from tracheostomy to sedation and ventilator weaning were 8 (95% CI 6–11) and 18 (95% CI 14–22) days, respectively (uncensored: 7 and 15 days). Median time from tracheostomy to decannulation was 36 (95% CI 32–47) days (uncensored: 32 days). Of those decannulated, 82% were decannulated during their index admission. There were no differences in outcomes or complication rates between percutaneous and open tracheostomy. Likelihood of discharge from the ICU was inversely related to intubation time, th ough the clinical relevance of this was small (HR 0.97, 95% CI 0.943–0.998; p = 0.037). Conclusion Tracheostomy by either percutaneous or open technique facilitated sedation and ventilator weaning in patients with COVID-19 after prolonged intubation. Additional study on the optimal timing of tracheostomy in patients with COVID-19 is warranted. Level of Evidence 3 This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.