Development of an institutional protocol for percutaneous dilatational tracheostomy in critically ill COVID-19 patients: Initial experience

• Published in: Journal of anaesthesiology, clinical pharmacology clinical pharmacology, 2022-01, Vol.38 (Suppl 1), p.S102-S106
• Main Authors: Damarla, Haritha, Pangasa, Neha, Hirolli, Divya, Jha, Parthadeep, Garg, Heena, Khan, Tazeen, Soni, Lipika, Maitra, Souvik, Anand, Rahul K., Ray, Bikash R., Baidya, Dalim K.
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2231-2730; 0970-9185; 0970-9185; 2231-2730
• DOI: 10.4103/joacp.joacp_495_21

Background and AimsPercutaneous dilatational tracheostomy (PDT) may improve the outcome in critically ill COVID-19 patients on mechanical ventilation. However, the timing of performing tracheostomy may be controversial, and it is an aerosol-generating procedure with a potential risk of viral exposure to healthcare workers. Material and MethodsAn operational protocol for performing PDT was made and subsequently followed in a designated COVID-19 ICU. Critically ill adult patients on mechanical ventilators who underwent PDT were included in this retrospective cohort study. Case files were retrospectively reviewed and patient characteristics, clinical outcome, and procedure-related details were noted. ResultsForty-one patients were included in the analysis. The median age was 49 (39-67) years, and 41.5% of patients were females. The median duration of mechanical ventilation before tracheostomy was 10 (8-16) days, and the median (IQR) PaO2/FiO2 ratio on the day of PDT was 155 (125-180) mm Hg. Further, 48.8% of patients had transient desaturation to SpO2