• Cristina Martin-Villares, Carmen Perez Molina-Ramirez, Margarita Bartolome-Benito, Manuel Bernal-Sprekelsen, and COVID ORL ESP Collaborative Group (*).
• Department of Otorhinolaryngology, Hospital Universitario El Bierzo, Médicos sin Fronteras s/n, 24401, Ponferrada, León, Spain. crismvillares@gmail.com.
• Eur Arch Otorhinolaryngol. 2021 May 1; 278 (5): 1605-1612.

BackgroundThe question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients.MethodsA multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp.Outcome Measurementscomplications, achieved weaning and decannulation and survival.ResultsWe performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4-42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients.ConclusionTo the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.

11 keywords...

hide…