Performing Tracheostomy in Intensive Care Unit- A Challenge during COVID-19 Pandemic

Main Article Content

Santosh Kumar Swain
http://orcid.org/0000-0001-7457-4443
Somadatta Das
http://orcid.org/0000-0002-5781-5839
Rabindra Nath Padhy
http://orcid.org/0000-0002-2522-9843

Abstract

COVID-19 is a rapidly spreading infection caused by novel corona virus. It is challenging to the medical community in an unprecedented degree. Clinicians and health care workers are at added risk of infection during the procedure performing at the intensive critical care unit. Tracheostomy is a common surgical procedure performed at ICU for prolonged ventilation of the patient. Performing tracheostomy is currently a challenging for otolaryngologist at the ICU because of high chance of spreads of the virus to the surrounding health care workers and also to the other patients. The location for this procedure in ICU should be well ventilated after the procedure and the pressure in the room must be maintained negative or neutral. The health care personnel particularly Otolaryngologists have a central role for managing this situations where they are assessing the patients, preventing the contamination to other assisting staff and other patients. As there is progressive rise of the COVID-19 patients worldwide, it is surely expected that several patients may need intubation and mechanical ventilation. So, in this condition, patient my require tracheostomy for prolonged ventilation. Because of the very minimum literature available  regarding tracheostomy in the COVID-19 pandemic, so this review article will surely increase awareness among health care personnel and surgical team for prevention of the transmission of the infection from tracheostomy to medical staffs and other patients.

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How to Cite
Swain, S. K., Das, S., & Padhy, R. N. (2020). Performing Tracheostomy in Intensive Care Unit- A Challenge during COVID-19 Pandemic . Siriraj Medical Journal, 72(5), 436-442. https://doi.org/10.33192/Smj.2020.59
Section
Review Article

References

1. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798):270-3
2.Tay JK, Khoo ML, Loh WS. Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngology–Head & Neck Surgery 2020 Mar 31.
3. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020 Published February 24, 2020. doi:10.1001/jama.2020.2648
4. Coronavirus disease 2019 (COVID-19)Situation Report –66. World Health Organization. March 26,2020 https://www.who.int/docs/defaultsource/ coronaviruse/situation-reports/20200326-sitrep-66-covid- 19.pdf?sfvrsn=81b94e61_2 March 27,2020.
5. Chee VW, Khoo ML, Lee SF, Lai YC, Chin NM. Infection control measures for operative procedures in severe acute respiratory syndrome-related patients. Anesthesiology 2004;100(6):1394-98.
6. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323 (11):1061-9.
7. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet 2020;395 (10223):497-506.
8. Zhejiang University School of Medicine: Handbook of COVID-19 Pre-vention and Treatment, 18/03/2020.2.
9. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, et al. Washington State 2019- nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382(10):929-36.
10. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382(13):1199–1207.
11.Hopkins C, Kumar N. Loss of sense of smell asmarker of COVID-19 infection [Internet]. The Royal College of Surgeons of England, Published Online, 2020, Mar 22 [cited 2020 Mar 24]. Available from: https://www.entuk.org/sites/default/files/files/Loss%20of% 20sense%20of%20smell%20as%20marker%20of%20COVID.pdf.
12. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine. 2020 ;8(4):420-2.
13.Swain SK,Sahu MC,Choudhury J, Bhattachaeyya B.Tracheostomy among pediatric patients:Our experiences at a tertiary care teaching hospital in Eastern India. Pediatrica Polska-Polish Journal of Paediatrics 2018;93(4):312-17.
14.Tay JK., Chung Khoo ML, Loh WS. Surgical Considerations fortracheostomy during the COVID-19 Pandemic. Lessons learned fromthe severe acute respiratory syndrome outbreak. JAMA OtolaryngolHead Neck Surg. Published online 31/03/2020. https://dx.doi.org/10.1001/jamaoto.2020.0764.
15.Damian B, Panayiotis K, Kevin S, Alistair S, Chetan K, Leandros V. Surgical tracheostomies in Covid-19 patients: Important considerations and the “5Ts” of safety. British Journal of Oral and Maxillofacial Surgery. 2020 Apr 16.
16.Ormandy D, Kapoor V, Kyzas PA, Vassiliou LV. Tracheostomy suspension:a modified approach for securing the airway. BJOMS 2020. In press.
17.Surgeons ACo. COVID-19: Guidance for Triage of Non-Emergent Surgical Procedures. 2020.
18. Wei WI, Tuen HH, Ng RW, Lam LK. Safe tracheostomy for patients with severe acute
respiratory syndrome. Laryngoscope 2003;113(10): 1777-1779. doi:10.1097/00005537-200310000-00022.

19. Chee VW, Khoo ML, Lee SF, Lai YC, Chin NM. Infection control measures for operative
procedures in severe acute respiratory syndrome–related patients. Anesthesiology. 2004; 100(6):1394-1398. doi:10.1097/00000542- 200406000-00010
20. Tien HC, Chughtai T, Jogeklar A, Cooper AB, Brenneman F. Elective and emergency surgery in (SARS). Can J Surg 2005;48(1):71-4.
21.Hosokawa K, Nishimura M, Egi M, Vincent JL. Timing of tracheotomy in ICU patients: a systematic review of randomized controlled trials. Critical care (London, England). 2015;19:424.
22. Wang F, Wu Y, Bo L, Lou J, Zhu J, Chen F,et al. The timing of tracheotomy in critically ill patients undergoing mechanical ventilation: a systematic review and meta-analysis of randomized controlled trials. Chest 2011;140(6):1456-65.
23.Cui Chong,Yao Qi,Zhang Di,Zhao Yu,Zhang Kun,Nisenbaum Eric.Approaching Otolaryngology Patients during the COVID-19 Pandemic.Otolaryngology and Head Neck surgery 2020.
24.Yu S, Yujuan H, Hongjun X. Recommendations for diagnosis and treatment of emergency diseases in ENT surgery during the prevention and control of new coronavirus. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. 2020.
25.Wei WI, Tuen HH, Ng RW, Lam LK. Safe tracheostomy for patients with severe acute respiratory syndrome. The Laryngoscope. 2003;113(10):1777-79.
26. Liu Y, Sun W, Li J, Chen L, Wang Y, Zhang L, et al. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. MedRxiv 2020 Jan 1.
27.Guidance for Surgical Tracheostomy and Tracheostomy Tube Change during the COVID-19 Pandemic https://www.entuk.org/tracheostomy-guidance-during-covid-19-pandemic March 27, 2020.
28. UW Medicine COVID-19 Resource Site - Minimizing Aerosolizing Procedures. University of Washington. https://covid-19.uwmedicine.org/Covid19 Policy Statements/Minimizing Aerosolizing Procedures.pdf. Published 2020. Accessed March 17, 2020.
29.Recommandations des sociétés savantes franc¸ aise d’ORL et Chirurgie Cervico-faciale (CNPORL S, SFORL, Collège Franc¸ ais d’ORL & CCF) 2020.
30. Young D, Harrison DA, Cuthbertson BH, Rowan K, TracMan C. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA 2013;309(20):2121-29.
31. Interim Infection Prevention and Control Recommendations for Patients with Suspected or
Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Centers for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/controlrecommendations. html. Published 2020. Accessed March 17, 2020.
32.Swain SK, Behera IC, Sahu MC. Bedside open tracheostomy at intensive care unit-our experiences of 1000 cases at a tertiary care teaching hospital of eastern India. Egyptian Journal of Ear, Nose, Throat and Allied Sciences 2017 ;18(1):49-53.