Bleeding Hazard of Percutaneous Tracheostomy in COVID-19 Patients Supported With Venovenous Extracorporeal Membrane Oxygenation: A Case Series

<h3>Objectives</h3><p dir="ltr"><u>Tracheostomy</u> usually is performed to aid <u>weaning from mechanical ventilation</u> and facilitate rehabilitation and secretion clearance. Little is known about the safety of percutaneous tracheostomy in patie...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hussam Elmelliti (17347060) (author)
مؤلفون آخرون: Dnyaneshwar Pandurang Mutkule (17347063) (author), Muhammad Imran (282621) (author), Nabil Abdelhamid Shallik (17347066) (author), Ali Ait Hssain (11264358) (author), Ahmed Labib Shehatta (17347069) (author)
منشور في: 2022
الموضوعات:
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الوصف
الملخص:<h3>Objectives</h3><p dir="ltr"><u>Tracheostomy</u> usually is performed to aid <u>weaning from mechanical ventilation</u> and facilitate rehabilitation and secretion clearance. Little is known about the safety of percutaneous tracheostomy in patients with severe COVID-19 supported on venovenous <u>extracorporeal membrane oxygenation</u> (VV-ECMO). This study aimed to investigate the bleeding risk of bedside percutaneous tracheostomy in patients with COVID-19 infection supported with VV-ECMO. </p><h3>Design</h3><p dir="ltr">A Retrospective review of electronic data for routine care of patients on ECMO. </p><h3>Setting</h3><p dir="ltr">Tertiary, university-affiliated national ECMO center. </p><h3>Participants</h3><p dir="ltr">Patients with COVID-19 who underwent percutaneous tracheostomy while on VV-ECMO support. </p><h3>Interventions</h3><p dir="ltr">No intervention was conducted during this study. </p><h3>Measurements and Main Results</h3><p dir="ltr"><u>Electronic medical records </u>of 16 confirmed patients with COVID-19 who underwent percutaneous tracheostomy while on VV-ECMO support, including patient demographics, severity of illness, clinical variables, procedural complications, and outcomes, were compared with 16 non-COVID-19 patients. The SPSS statistical software was used for statistical analysis. The demographic data were compared using the chi-square test, and normality assumption was tested using the Shapiro-Wilk test. The indications for tracheostomy in all the patients were prolonged <u>mechanical ventilation</u> and sedation management. None of the patients suffered a life-threatening procedural complication within 48 hours. Moderate-to-severe bleeding was similar in both groups. There was no difference in 30- and 90-days mortality between both groups. As per routine screening results, none of the staff involved contracted COVID-19 infection. </p><h3>Conclusions</h3><p dir="ltr">In this case series, percutaneous tracheostomy during VV-ECMO in patients with COVID-19 appeared to be safe and did not pose additional risks to patients or healthcare workers.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Cardiothoracic and Vascular Anesthesia<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1053/j.jvca.2022.09.084" target="_blank">https://dx.doi.org/10.1053/j.jvca.2022.09.084</a></p>