@article{955ca41baefc43d9be5befe9f7d57325,
title = "Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19 Complication rates, relative risks and benefits",
abstract = "Objective: Patients with acute respiratory failure due to COVID-19 have a high likelihood of needing prolonged intubation and may subsequently require tracheotomy. Usually, the choice of technique (percutaneous dilatational tracheotomy [PDT] versus open surgical tracheotomy [OST]) depends on the preference of surgeons and patient-related factors. In case of COVID-19, airborne spread of viral particles and limited time of apnea must be considered in the choice of the safest technique. The aim of this study is to compare the complication rates and offer an assessment of relative risks and benefits of PDT versus OST in patients with severe COVID-19. Methods: We performed a retrospective study considering 47 consecutive patients affected by severe acute respiratory distress syndrome due to SARS-CoV-2 infection, needing invasive mechanical ventilation and subsequent tracheostomy. This study was performed at the Intensive Care Unit of our tertiary referral center. Complication rates were analyzed. Results: Seventeen patients underwent PDT and 30 patients were submitted to OST. Twenty-six patients (55.3%) had post-operative complications (local infection, hemorrhage, subcutaneous emphysema) with no significant difference between PDT and OST. Conclusion: PDT and OST are characterized by similar postoperative complication rates in severe COVID-19 patients. These findings suggest that OST might be preferred if expert ENT surgeons are available, as PDT could result in longer apnea and exposure to generated aerosol. However, authors recommend considering either OST or PDT at the discretion of the medical staff involved, according to the personal experience of the operators performing the procedure.",
keywords = "Complication, COVID-19, Percutaneous, Surgical, Tracheostomy, Tracheotomy",
author = "Cecilia Botti and Francesca Lusetti and Tommaso Neri and Stefano Peroni and Andrea Castellucci and Pierpaolo Salsi and Angelo Ghidini",
note = "Funding Information: None. None. Cecilia Botti: conception and design of the work; acquisition, analysis, and interpretation of data; drafting the work, final approval of the version to be published agreement to be accountable for all aspects of the work. Francesca Lusetti: acquisition, analysis, and interpretation of data; final approval of the version to be published; agreement to be accountable for all aspects of the work. Tommaso Neri: acquisition, analysis, and interpretation of data; final approval of the version to be published; agreement to be accountable for all aspects of the work. Stefano Peroni: acquisition, analysis, and interpretation of data; final approval of the version to be published; agreement to be accountable for all aspects of the work. Andrea Castellucci: interpretation of data; revising the work critically for important intellectual content; final approval of the version to be published agreement to be accountable for all aspects of the work. Pierpaolo Salsi: interpretation of data; revising the work critically for important intellectual content; final approval of the version to be published agreement to be accountable for all aspects of the work. Angelo Ghidini: conception and design of the work; interpretation of data; revising the work critically for important intellectual content; final approval of the version to be published agreement to be accountable for all aspects of the work. All authors declare they have no financial support nor relationships that may pose a conflict of interest. Publisher Copyright: {\textcopyright} 2020 Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = oct,
day = "28",
doi = "10.1016/j.anl.2020.10.014",
language = "English",
journal = "Auris Nasus Larynx",
issn = "0385-8146",
publisher = "Elsevier Ireland Ltd",
}