Bronchoscopy-guided percutaneous tracheostomy in COVID-19 patients
V. Ruiz*a (Dr), I. Carboni Bissoa (Dr), F. Rosciania (Dr), J. Cantosa (Dr), M. Las Herasa (Dr)
a Hospital Italiano de Buenos Aires, Buenos Aires, ARGENTINA
To assess the efficacy and complications associated with performing bronchoscopy-guided percutaneous tracheostomy (PT) in COVID-19 patients.
Prospective observational study conducted between march 2020 and february 2022. Adult patients who underwent elective bronchoscopy-guided PT were included. The efficacy of the procedure was evaluated based on the success rate in the execution or the need for conversion to open technique. Also early and late complications observed were recorded.
During the study period, 312 bronchoscopy-guided percutaneous tracheostomies were analyzed. One hundred and eighty-three were performed in COVID-19 patients and 129 among non-COVID-19 patients. Overall, 64.1% (200) of patients were male, with a median age of 66 (IQR 54 - 74). Sixty-five percent (205) presented at least one comorbidity.
Overall, oxygen desaturation was the main complication observed (20.8% ), but it was more frequent in the COVID-19 group occurring in 27.3% (50), with a statistically significant difference vs the non-COVID-19 patients' group (11.6% ); p<0.01). Also, major complications such as hypotension, arrhythmias and pneumothorax were more frequently observed among COVID-19 patients but without significant differences.
PT could be executed quickly and satisfactorily in all the patients without the need for conversion to the open technique. Likewise, no suspension of the procedure was required in any case.
Bronchoscopy-guided PT is an effective and safe procedure in COVID-19 patients. Nevertheless, it is highly remarkable that in our series a great number of COVID-19 patients presented desaturation during the procedure.
Keywords: tracheostomy; bronchoscopy; critical care
Abbott, Francisco, Marcos Ortega, Sebastian Bravo, Roque Basoalto, and Eduardo Kattan. 2021. “Can We Improve Teaching and Learning of Percutaneous Dilatational Tracheostomy’s Bronchoscopic Guidance?” SAGE Open Medicine 9 (March): 20503121211002321.
Disclosure of funding source(s): none