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Tracheostomy in intensive care unit in a patient with COVID-19

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Wyrzykowska D., Kisielewski K., Sawicka M., Mitura K.
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INTRODUCTION: For many months now, the entire world experiences effects of the COVID-19 pandemic, and current data indicate that this condition will continue even longer. About 5% of patients who become infected with the SARSCoV-2 coronavirus may develop a critical form of severe respiratory failure, due to which they will undergo intubation and mechanical ventilation. Prolonged mechanical ventilation will be an indication for an open tracheostomy, burdened with an increased production of aerosol containing virus particles and an increased risk of transmitting the highly contagious pathogen to medical personnel. In this situation, surgical departments with a limited number of operating theaters may be dedicated only to COVID-19 patients. Their use for other procedures will be significantly reduced or even impossible to prevent transmission of infections and exposure to other people. Taking into account the well-being of patients and staff and limiting the transmission of the virus to other departments, other safe solutions are being sought to perform a tracheostomy. An alternative procedure may be to perform a tracheostomy directly at the bedside (point-of-care) of a patient hospitalized in an intensive care unit (ICU). PURPOSE: The purpose of the study is to present an effective performance of safe, open tracheostomy in the ICU. METHODS: The bedside tracheotomy as an alternative to the procedure performed in the setting of an operating theater has been presented. A case study was based on the analysis of the procedure performed in a 42-year-old patient who was installed an open tracheotomy tube on the twenty-ninth day of intubation. CONCLUSIONS: In order to limit the transmission of the SARS-CoV-2 coronavirus outside the intensive care unit, it is recommended to perform a tracheotomy in ICU, in patients requiring mechanical ventilation, as the method is effective and safe.
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