Key Points
- Current ENT-UK guidance recommends performing tracheostomy for weaning
in COVID-19 pneumonitisafter 14 days of intubation, the BLA recommend
a PEEP of ≤ 10cm H20 and an Fi02 of ≤ 0.4
- 51patients with COVID-19 underwent tracheostomy for weaning of
mechanical ventilation. 72.5% occurred on or after day 14. The
average PEEP was 8 and Fi02 0.35.
- Percutaneous tracheostomy has recently been advocated as the preferred
technique. We present an airway management algorithm utilising
ultrasound and bronchoscopy to reduce the risk of intra-operative cuff
puncture or misplacement, whilst minimising aerosol generation.
- None of the surveyed healthcare workers were clinically or PCR-test
positive for COVID-19 in the relevant 5-14 day window post-procedure.
- This preliminary report on outcomes infers most patients stop sedation
within 5 days of tracheostomy, discharge from ICU and decannulation
mostly happens by day 15. The mortality rate was 3.9%; deaths were
not tracheostomy-related.