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Coronavirus disease tracheostomy complications: a scoping review

Published online by Cambridge University Press:  11 October 2022

E Rosario Open the ORCID record for E Rosario [Opens in a new window] ,
T Ross ,
M Komorowski  and
N Tolley
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
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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.

Keywords

Critical CareCOVID-19Postoperative ComplicationsTracheostomySARS-CoV-2

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 1 , January 2023 , pp. 7 - 16
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

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