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Title: SARS-CoV-2 transmission risk to healthcare workers performing tracheostomies: a systematic review.
Austin Authors: Subramaniam, Ashwin;Lim, Zheng Jie;Ponnapa Reddy, Mallikarjuna;Mitchell, Hayden;Shekar, Kiran
Affiliation: Anaesthesia..
Department of Medicine, Peninsula Health, Frankston, Victoria, Australia
Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia
School of Medicine, University of Queensland, Brisbane, Queensland, Australia
Institute of Health and Biomedical innovation, University of Technology Brisbane, Brisbane, Queensland, Australia
Department of Intensive Care Medicine, Peninsula Health, Melbourne, Victoria.. Monash University, Peninsula Clinical School, Melbourne, Victoria, Australia
School of Medicine, Bond University, Gold Coast, Queensland, Australia
Australian and New Zealand Intensive Care Research Centre (ANZIC RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Intensive Care Medicine, Peninsula Health, Melbourne, Victoria..
Department of Intensive Care Medicine, Calvary Hospital, Canberra, Australian Capital Territory, Australia
Issue Date: 2-Jun-2022 2022
Publication information: ANZ journal of surgery 2022; 92(7-8): 1614-1625
Abstract: Tracheostomy is a commonly performed procedure in patients with coronavirus disease 2019 (COVID-19) receiving mechanical ventilation (MV). This review aims to investigate the occurrence of SARS-CoV-2 transmission from patients to healthcare workers (HCWs) when tracheostomies are performed. This systematic review used the preferred reporting items for systematic reviews and meta-analysis framework. Studies reporting SARS-CoV-2 infection in HCWs involved in tracheostomy procedures were included. Sixty-nine studies (between 01/11/2019 and 16/01/2022) reporting 3117 tracheostomy events were included, 45.9% (1430/3117) were performed surgically. The mean time from MV initiation to tracheostomy was 16.7 ± 7.9 days. Location of tracheostomy, personal protective equipment used, and anaesthesia technique varied between studies. The mean procedure duration was 14.1 ± 7.5 minutes; was statistically longer for percutaneous tracheostomies compared with surgical tracheostomies (mean duration 17.5 ± 7.0 versus 15.5 ± 5.6 minutes, p = 0.02). Across 5 out of 69 studies that reported 311 tracheostomies, 34 HCWs tested positive for SARS-CoV-2 and 23/34 (67.6%) were associated with percutaneous tracheostomies. In this systematic review we found that SARS-CoV-2 transmission to HCWs performing or assisting with a tracheostomy procedure appeared to be low, with all reported transmissions occurring in 2020, prior to vaccinations and more recent strains of SARS-CoV-2. Transmissions may be higher with percutaneous tracheostomies. However, an accurate estimation of infection risk was not possible in the absence of the actual number of HCWs exposed to the risk during the procedure and the inability to control for multiple confounders related to variable timing, technique, and infection control practices.
DOI: 10.1111/ans.17814
ORCID: 0000-0002-8292-7357
Journal: ANZ journal of surgery
PubMed URL: 35655401
PubMed URL:
Type: Journal Article
Subjects: COVID-19
healthcare worker
Appears in Collections:Journal articles

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