A study on the Safety of Percutaneous Tracheostomy in Patients with Severe Acute Respiratory Syndrome Novel Corona Virus 2 (SARS-nCoV2) Infection: A Single-center Observational Cohort Study in a CoVID Intensive Care Unit [post]

Krishna Kumar, Aditya Joshi, Ranjith Nair, Rangraj Setlur, Rajan Kapoor
2021 unpublished
Background: We studied the safety of percutaneous dilatational tracheostomy (PCDT) in severe acute respiratory syndrome novel coronavirus 2 (SARS-nCoV2). Patients & Methods: From 01 March 20 to 30 November 2020, 1635 required hospital admission of which 145 (9%) required intensive (ICU) care. The primary outcomes are mortality and secondary outcomes were duration of invasive mechanical ventilation (IMV), length of stay (LOS) in ICU and hospital, & days required for decannulation.Results: Out of
more » ... the 145 (9%), 107 (73.7%) were males (mean 61.4 years, median body mass index (BMI) of 28.2 kg/m2 ), 38 (26.2%) were females (mean 58.10 years, median BMI of 31.2 kg/m2). In the cohort of 80 (55.17%) requiring IMV, 19 (23.7%) died within 72 hours and were not included in the study, 37 (group "NT") and 24 (group "T") had a median duration of ventilation of 9 d (IQR, 6-11) and 12 d (IQR, 11-17.25) respectively. Patients in group "T" underwent PCDT based on clinical criteria (fraction of inspired oxygen (FiO2 ) of ≤ 50% with positive end-expiratory pressure (PEEP) of ≤ 10 cms of H2O with stable hemodynamics), 16 (66.7%) had survived. The reverse transcription-polymerase chain reaction (RT-PCR) does not need to be negative, and none of the health care workers (HCW's) were infected. The Cox-hazard ratio [HR] is 0.19, 95% Confidence interval [CI] (0.09, 0.41) with a P-value of <0.001, 83 (57.2%) were discharged with a mortality of 42.8%. Conclusions: PCDT is safe and effective in patients anticipated in need of prolonged mechanical ventilation.
doi:10.21203/rs.3.rs-307467/v1 fatcat:fbyk7hhnunghzlkyqf3lw2lxhu