Journal of Clinical Medicine (Jun 2021)
Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study
- Denise Battaglini,
- Francesco Missale,
- Irene Schiavetti,
- Marta Filauro,
- Francesca Iannuzzi,
- Alessandro Ascoli,
- Alberto Bertazzoli,
- Federico Pascucci,
- Salvatore Grasso,
- Francesco Murgolo,
- Simone Binda,
- Davide Maraggia,
- Giorgia Montrucchio,
- Gabriele Sales,
- Giuseppe Pascarella,
- Felice Eugenio Agrò,
- Gaia Faccio,
- Sandra Ferraris,
- Savino Spadaro,
- Giulia Falò,
- Nadia Mereto,
- Alessandro Uva,
- Jessica Giuseppina Maugeri,
- Bellissima Agrippino,
- Maria Vargas,
- Giuseppe Servillo,
- Chiara Robba,
- Lorenzo Ball,
- Francesco Mora,
- Alessio Signori,
- Antoni Torres,
- Daniele Roberto Giacobbe,
- Antonio Vena,
- Matteo Bassetti,
- Giorgio Peretti,
- Patricia R. M. Rocco,
- Paolo Pelosi
Affiliations
- Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Francesco Missale
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Irene Schiavetti
- Department of Health Sciences, Section of Biostatistics, University of Genoa, 16132 Genoa, Italy
- Marta Filauro
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Francesca Iannuzzi
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Alessandro Ascoli
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Alberto Bertazzoli
- First Division of Anesthesiology and Intensive Care Unit, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
- Federico Pascucci
- First Division of Anesthesiology and Intensive Care Unit, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
- Salvatore Grasso
- Dipartimento dell’Emergenza e Trapianti d’Organo (DETO), Sezione di Anestesiologia e Rianimazione, Università degli Studi di Bari “Aldo Moro”, Ospedale Policlinico, 70124 Bari, Italy
- Francesco Murgolo
- Dipartimento dell’Emergenza e Trapianti d’Organo (DETO), Sezione di Anestesiologia e Rianimazione, Università degli Studi di Bari “Aldo Moro”, Ospedale Policlinico, 70124 Bari, Italy
- Simone Binda
- Anaesthesia and Intensive Care Department, University Hospital, Ospedale di Circolo, 21100 Varese, Italy
- Davide Maraggia
- Anaesthesia and Intensive Care Department, University Hospital, Ospedale di Circolo, 21100 Varese, Italy
- Giorgia Montrucchio
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, 10121 Turin, Italy
- Gabriele Sales
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, 10121 Turin, Italy
- Giuseppe Pascarella
- Department of Anaesthesia, Intensive Care and Pain Management, Universita Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy
- Felice Eugenio Agrò
- Department of Anaesthesia, Intensive Care and Pain Management, Universita Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy
- Gaia Faccio
- U.O. di Anestesia e Rianimazione, Ospedale di Treviglio-Caravaggio, 24047 Treviglio, Italy
- Sandra Ferraris
- U.O. di Anestesia e Rianimazione, Ospedale di Treviglio-Caravaggio, 24047 Treviglio, Italy
- Savino Spadaro
- Department of Morphology, Surgery and Experimental Medicine, Faculty of Medicine, University of Ferrara, 44121 Ferrara, Italy
- Giulia Falò
- Department of Morphology, Surgery and Experimental Medicine, Faculty of Medicine, University of Ferrara, 44121 Ferrara, Italy
- Nadia Mereto
- Anestesia e Rianimazione, Ospedale Villa Scassi, 16132 Genoa, Italy
- Alessandro Uva
- Anestesia e Rianimazione, Ospedale Villa Scassi, 16132 Genoa, Italy
- Jessica Giuseppina Maugeri
- Anesthesia and Intensive Care, “Garibaldi Centro” Hospital, ARNAS Garibaldi, 95100 Catania, Italy
- Bellissima Agrippino
- Anesthesia and Intensive Care, “Garibaldi Centro” Hospital, ARNAS Garibaldi, 95100 Catania, Italy
- Maria Vargas
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Università degli Studi di Napoli Federico II, 80126 Napoli, Italy
- Giuseppe Servillo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Università degli Studi di Napoli Federico II, 80126 Napoli, Italy
- Chiara Robba
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Lorenzo Ball
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Francesco Mora
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genoa, 16132 Genoa, Italy
- Antoni Torres
- Department of Pulmonology, Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911-Ciber de Enfermedades Respiratorias (CIBERES), 08007 Barcelona, Spain
- Daniele Roberto Giacobbe
- Dipartimento di Scienze della Salute (DISSAL), Università degli Studi di Genova, 16132 Genova, Italy
- Antonio Vena
- Clinica Malattie Infettive, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) per l’Oncologia e le Neuroscienze, 16132 Genova, Italy
- Matteo Bassetti
- Dipartimento di Scienze della Salute (DISSAL), Università degli Studi di Genova, 16132 Genova, Italy
- Giorgio Peretti
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- Patricia R. M. Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil
- Paolo Pelosi
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, 16132 Genoa, Italy
- DOI
- https://doi.org/10.3390/jcm10122651
- Journal volume & issue
-
Vol. 10,
no. 12
p. 2651
Abstract
Background: Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications. Methods: A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous). Results: The median time to tracheostomy was 15 (1–64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (p p = 0.050). The rate of lower respiratory tract infections was higher with surgical versus percutaneous technique (p = 0.007). Conclusions: Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.
Keywords
