Tracheostomy in patients with SARS-CoV-2 reduces time on mechanical ventilation but not intensive care unit stay

• Published in: American journal of otolaryngology 2021-03, Vol.42 (2), p.102867-102867, Article 102867
• Main Authors: Mata-Castro, Nieves, Sanz-López, Lorena, Pinacho-Martínez, Paloma, Varillas-Delgado, David, Miró-Murillo, Miguel, Martín-Delgado, María Cruz
• Format: Article
• Language: English
• Subjects: Aged; Coronaviruses; COVID-19; COVID-19 - mortality; COVID-19 - therapy; Cross-Sectional Studies; Female; Hospital Mortality; Humans; Infections; Influence; Intensive care; Intensive care unit; Intensive Care Units; Intubation; Length of Stay - statistics & numerical data; Male; Mechanical ventilation; Medical prognosis; Middle Aged; Mortality; Ostomy; Patients; Pneumonia; Respiration, Artificial; Respiratory diseases; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Spain; Time Factors; Tracheostomy; Tracheotomy; Ventilation; Ventilators
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2020.102867

Cross-sectional study to know if tracheostomy influences the time on mechanical ventilation and reduces the ICU stay in patients with SARS-CoV2. From February 14 to May 31, 2020, 29 patients: 23 men and 6 women, with an average age (SD) of 66.4 years (±6,2) required tracheostomy. The average intensive care unit (ICU) stay was 36 days [31–56.5]. The average days on mechanical ventilation was 28,5 days (±9.7). Mean time to tracheostomy was 15.2 days (±9.5) with an average disconnection time after procedure of 11.3 days (±7.4). The average hospital stay was 55 days [39–79]. A directly proportional relation between the number of days of MV and the number of days from ICU admission until tracheostomy showed a significant value of p = 0.008. For each day of delay in tracheostomy, the days of mechanical ventilation were increased by 0.6 days. There was no relation between days to tracheostomy and days to disconnection (p = 0.092). PaO2 / FiO2 (PAFI) before tracheostomy and Simplified Acute Physiology Score III (SAPS III) at admission presented a statistical relation with mortality, with an OR of 1.683 (95%CI; 0.926–2.351; p = 0.078) and an OR of 1.312 (CI95%: 1.011–1.703; p = 0.034) respectively. The length of stay in the ICU until the tracheostomy was not related to the risk of death (p = 0.682). PEEP and PaO2/FiO2 (PAFI) at admission and before tracheostomy and APACHE II, SAPS III and SOFA at admission did not show influence over time on MV. We conclude that the delay in tracheostomy increase the days on mechanical ventilation but does not influence stay or mortality. •For each day of delay in tracheostomy, the days of mechanical ventilation were increased by 0.6 days.•Timing of the tracheostomy did not influence days of disconnection from mechanical ventilation, ICU stay, or mortality.•There was no relationship between days to tracheostomy and days to disconnection.•Respiratory variables (PEEP and PaO2 / FiO2 on admission and before tracheostomy) and patient severity scales (APACHE II, SAPS III and SOFA on admission) did not show influence over time on mechanical ventilation.•The length of stay in the ICU until the tracheostomy was not related to the risk of death.