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Title: Tracheostomy in the COVID-19 era: global and multidisciplinary guidance.
Austin Authors: McGrath, Brendan A;Brenner, Michael J;Warrillow, Stephen J ;Pandian, Vinciya;Arora, Asit;Cameron, Tanis S ;Añon, José Manuel;Hernández Martínez, Gonzalo;Truog, Robert D;Block, Susan D;Lui, Grace C Y;McDonald, Christine F ;Rassekh, Christopher H;Atkins, Joshua;Qiang, Li;Vergez, Sébastien;Dulguerov, Pavel;Zenk, Johannes;Antonelli, Massimo;Pelosi, Paolo;Walsh, Brian K;Ward, Erin;Shang, You;Gasparini, Stefano;Donati, Abele;Singer, Mervyn;Openshaw, Peter J M;Tolley, Neil;Markel, Howard;Feller-Kopman, David J
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Universitätsklinikum Augsburg Klinik für HNO-Heilkunde, Augsburg, Germany
Manchester University NHS Foundation Trust, Manchester, UK
Center for Bioethics, Harvard Medical School, Boston, MA, USA
Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
Anesthesia and Intensive Care, San Martino Policlinico Hospital, Genoa, Italy
Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
University of Michigan, Ann Arbor, USA
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Johns Hopkins University, Baltimore, MD, USA
Guy's and St Thomas' NHS Foundation Trust, London, UK
La Paz-Carlos III University Hospital, IdiPAZ, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
Virgen de la Salud Hospital, Health Service of Castilla-La Mancha, Toledo, Spain
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
University of Pennsylvania, Philadelphia, PA, USA
East Hospital of Shanghai, TongJi University, Shanghai, China
University Hospital Rangueil-Larrey, Toulouse, France
Hôpital de la Tour, Meyrin, Geneva University, Geneva, Switzerland
Dipartimento di Scienze dell' Emergenza Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
Liberty University, Lynchburg, VA, USA
Tracheostomy Team, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, MA, USA
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Region - Azienda Ospedali Riuniti, Ancona, Italy
University College London, London, UK
National Heart and Lung Institute, Imperial College of London, London, UK
Imperial College Healthcare NHS Trust, London, UK
University of Michigan, Ann Arbor, USA
Johns Hopkins University, Baltimore, MD, USA
Tracheostomy Review and Management Service
Issue Date: 15-May-2020 2020-05-15
Publication information: The Lancet. Respiratory medicine 2020; online first: 15 May
Abstract: Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.
DOI: 10.1016/S2213-2600(20)30230-7
ORCID: 0000-0002-7240-4106
PubMed URL: 32422180
Type: Journal Article
Subjects: COVID-19
Appears in Collections:Journal articles

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