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Coronavirus disease tracheostomy complications: a scoping review

Published online by Cambridge University Press:  11 October 2022

E Rosario*
Affiliation:
Department of Intensive Care, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
T Ross
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, University College London Hospitals, London, UK
M Komorowski
Affiliation:
Department of Intensive Care, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
N Tolley
Affiliation:
Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK Department of Otolaryngology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Author for correspondence: Dr Eleanor Rosario, Department of Intensive Care, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK E-mail: eleanor.rosario@nhs.net

Abstract

Background

Coronavirus disease 2019 increased the numbers of patients requiring prolonged mechanical ventilation, with a subsequent increase in tracheostomy procedures. Coronavirus disease 2019 patients are high risk for surgical complications. This review examines open surgical and percutaneous tracheostomy complications in coronavirus disease 2019 patients.

Methods

Medline and Embase databases were searched (November 2021), and the abstracts of relevant articles were screened. Data were collected regarding tracheostomy technique and complications. Complication rates were compared between percutaneous and open surgical tracheostomy.

Results

Percutaneous tracheostomy was higher risk for bleeding, pneumothorax and false passage. Surgical tracheostomy was higher risk for peri-operative hypoxia. The most common complication for both techniques was post-operative bleeding.

Conclusion

Coronavirus disease 2019 patients undergoing tracheostomy are at higher risk of bleeding and peri-operative hypoxia than non-coronavirus disease patients. High doses of anti-coagulants may partially explain this. Reasons for higher bleeding risk in percutaneous over open surgical technique remain unclear. Further research is required to determine the causes of differences found and to establish mitigating strategies.

Type
Review Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Rosario takes responsibility for the integrity of the content of the paper

References

Abate, SM, Ahmed Ali, S, Mantfardo, B, Basu, B. Rate of intensive care unit admission and outcomes among patients with coronavirus: a systematic review and meta-analysis. PLoS One 2020;15:e0235653CrossRefGoogle ScholarPubMed
Shryane, N, Pampaka, M, Aparicio-Castro, A, Ahmad, S, Elliot, MJ, Kim, J et al. Length of stay in ICU of Covid-19 patients in England, March - May 2020. Int J Popul Data Sci 2021;5:1411Google ScholarPubMed
Meister, KD, Pandian, V, Hillel, AT, Walsh, BK, Brodsky, MB, Balakrishnan, K et al. Multidisciplinary safety recommendations after tracheostomy during COVID-19 pandemic: state of the art review. Otolaryngol Head Neck Surg 2021;164:9841000CrossRefGoogle ScholarPubMed
Young, D, Harrison, DA, Cuthbertson, BH, Rowan, K, TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA 2013;309:2121–9CrossRefGoogle ScholarPubMed
Añón, JM, Araujo, JB, Escuela, MP, González-Higueras, E. Percutaneous tracheostomy in the ventilated patient. Med Intensiva 2014;38:181–93CrossRefGoogle ScholarPubMed
Livneh, N, Mansour, J, Kassif Lerner, R, Feinmesser, G, Alon, E. Early vs. late tracheostomy in ventilated COVID-19 patients – a retrospective study. Am J Otolaryngol 2021;42:103102CrossRefGoogle ScholarPubMed
Reis, LR, Castelhano, L, Gani, K, Almeida, G, Escada, P. Tracheostomy in COVID-19 patients: experience at a tertiary center in the first 11 months of the pandemic. Indian J Otolaryngol Head Neck Surg 2021. Epub 2021 Aug 15Google Scholar
Ferri, E, Boscolo Nata, F, Pedruzzi, B, Campolieti, G, Scotto di Clemente, F, Baratto, F et al. Indications and timing for tracheostomy in patients with SARS CoV2-related. Eur Arch Otorhinolaryngol 2020;277:2403–4CrossRefGoogle ScholarPubMed
Gosling, AF, Bose, S, Gomez, E, Parikh, M, Cook, C, Sarge, T et al. Perioperative considerations for tracheostomies in the era of COVID-19. Anesth Analg 2020;131:378–86CrossRefGoogle ScholarPubMed
Polok, K, Fronczek, J, van Heerden, PV, Flaatten, H, Guidet, B, De Lange, DW et al. Association between tracheostomy timing and outcomes for critically ill COVID-19 patients aged ≥70 years: prospective observational study in European intensive care units. Br J Anaesth 2022;128:482–90CrossRefGoogle Scholar
COVIDTrach collaborative. COVIDTrach: a prospective cohort study of mechanically ventilated patients with COVID-19 undergoing tracheostomy in the UK. BMJ Surg Interv Health Technol 2021;3:e000077CrossRefGoogle Scholar
Williams, T, McGrath, BA. Tracheostomy for COVID-19: evolving best practice. Crit Care 2021;25:316CrossRefGoogle ScholarPubMed
Battaglini, D, Missale, F, Schiavetti, I, Filauro, M, Iannuzzi, F, Ascoli, A et al. Tracheostomy timing and outcome in severe COVID-19: the WeanTrach Multicenter Study. J Clin Med 2021;10:2651CrossRefGoogle ScholarPubMed
Al Omari, A, Al-Ashqar, R, Alabd Alrhman, R, Nuseir, A, Allan, H, Alzoubi, F. Assessment of the harms and potential benefits of tracheostomy in COVID-19 patients: narrative review of outcomes and recommendations. Am J Otolaryngol 2021;42:102972CrossRefGoogle ScholarPubMed
Schultz, P, Morvan, J-B, Fakhry, N, Morinière, S, Vergez, S, Lacroix, C et al. French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020;137:167–9CrossRefGoogle ScholarPubMed
Bertini, P, Forfori, F, Bruschini, L, Corradi, F, Ribechini, A, Brogi, E et al. Percutaneous tracheostomy in COVID-19 critically ill patients: experience from 30 consecutive procedures. Int Arch Otorhinolaryngol 2021;25:e135–40Google ScholarPubMed
Mesalles-Ruiz, M, Hamdan, M, Huguet-Llull, G, Penella, A, Portillo, A, Bagudà, E et al. Outcomes and survival of tracheostomised patients during the COVID-19 pandemic in a third level hospital. Eur Arch Otorhinolaryngol 2022;279:3095–103CrossRefGoogle Scholar
Wilkinson, K, Freeth, H, Kelly, K. ‘On the right trach?’ A review of the care received by patients who undergo tracheostomy. Br J Hosp Med (Lond) 2015;76:163–5CrossRefGoogle ScholarPubMed
Ferro, A, Kotecha, S, Auzinger, G, Yeung, E, Fan, K. Systematic review and meta-analysis of tracheostomy outcomes in COVID-19 patients. Br J Oral Maxillofac Surg 2021;59:1013–23CrossRefGoogle ScholarPubMed
Carfora, V, Spiniello, G, Ricciolino, R, Di Mauro, M, Migliaccio, MG, Mottola, FF et al. Anticoagulant treatment in COVID-19: a narrative review. J Thromb Thrombolysis 2021;51:642–8CrossRefGoogle ScholarPubMed
Jiménez, D, García-Sanchez, A, Rali, P, Muriel, A, Bikdeli, B, Ruiz-Artacho, P et al. Incidence of VTE and bleeding among hospitalized patients with coronavirus disease 2019. Chest 2021;159:1182–96CrossRefGoogle ScholarPubMed
Wahid, L, Ortel, TL. Anticoagulant therapy in patients hospitalized with COVID-19. JAMA Intern Med 2021;181:1621CrossRefGoogle ScholarPubMed
REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators. Therapeutic anticoagulation with heparin in critically ill patients with Covid-19. N Engl J Med 2021;385:777–89CrossRefGoogle Scholar
National Institute for Health and Care Excellence. COVID-19 rapid guideline: Managing COVID-19. In: https://www.nice.org.uk/guidance/ng191/resources/covid19-rapid-guideline-managing-covid19-pdf-51035553326 [25 January 2022]Google Scholar
Johnson-Obaseki, S, Veljkovic, A, Javidnia, H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients: surgical versus percutaneous tracheostomy. Laryngoscope 2016;126:2459–67CrossRefGoogle ScholarPubMed
Brass, P, Hellmich, M, Kullmer, B, Ladra, A, Ladra, J. Percutaneous technique versus surgical techniques for tracheostomy. Cochrane Database Syst Rev 2016;(7):CD008045Google ScholarPubMed
Broderick, D, Kyzas, P, Sanders, K, Sawyerr, A, Katre, C, Vassiliou, L. Surgical tracheostomies in Covid-19 patients: important considerations and the “5Ts” of safety. Br J Oral Maxillofac Surg 2020;58:585–9CrossRefGoogle ScholarPubMed
Halum, SL, Ting, JY, Plowman, EK, Belafsky, PC, Harbarger, CF, Postma, GN et al. A multi-institutional analysis of tracheotomy complications. Laryngoscope 2012;122:3845CrossRefGoogle ScholarPubMed
Cordes, SR, Best, AR, Hiatt, KK. The impact of obesity on adult tracheostomy complication rate. Laryngoscope 2015;125:105–10CrossRefGoogle ScholarPubMed
Dhont, S, Derom, E, Van Braeckel, E, Depuydt, P, Lambrecht, BN. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 2020;21:198CrossRefGoogle ScholarPubMed
McGrath, BA, Brenner, MJ, Warrillow, SJ, Pandian, V, Arora, A, Cameron, TS et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med 2020;8:717–25CrossRefGoogle ScholarPubMed
Jones, H, Gendre, A, Walshe, P, Walsh, M, Glynn, F, Lacy, P et al. The Royal College of Surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients. Surgeon 2021;19:e265–9CrossRefGoogle ScholarPubMed
Shivnani, D, Raman, EV, Amle, D. The COVID TIDE approach: a protocol for safe tracheostomy practice in COVID patients. Indian J Otolaryngol Head Neck Surg 2021;73:197206CrossRefGoogle ScholarPubMed
Martinelli, AW, Ingle, T, Newman, J, Nadeem, I, Jackson, K, Lane, ND et al. COVID-19 and pneumothorax: a multicentre retrospective case series. Eur Respir J 2020;56:2002697CrossRefGoogle ScholarPubMed
Scholfield, DW, Warner, E, Ahmed, J, Ghufoor, K. Subglottic and tracheal stenosis associated with coronavirus disease 2019. J Laryngol Otol 2021;135:656–8CrossRefGoogle ScholarPubMed