PT  - JOURNAL ARTICLE
AU  - Miguel J Divo
AU  - Catherine L Oberg
AU  - Michael A Pritchett
AU  - Bartolome R Celli
AU  - Erik E Folch
TI  - Methods for a Seamless Transition From Tracheostomy to Spontaneous Breathing in Patients With COVID-19
AID  - 10.4187/respcare.08157
DP  - 2020 Nov 01
TA  - Respiratory Care
PG  - 1773--1783
VI  - 65
IP  - 11
4099  - http://rc.rcjournal.com/content/65/11/1773.short
4100  - http://rc.rcjournal.com/content/65/11/1773.full
AB  - The COVID-19 pandemic has profoundly affected health care delivery worldwide. A small yet significant number of patients with respiratory failure will require prolonged mechanical ventilation while recovering from the viral-induced injury. The majority of reports thus far have focused on the epidemiology, clinical factors, and acute care of these patients, with less attention given to the recovery phase and care of those patients requiring extended time on mechanical ventilation. In this paper, we review the procedures and methods to safely care for patients with COVID-19 who require tracheostomy, gastrostomy, weaning from mechanical ventilation, and final decannulation. The guiding principles consist of modifications in the methods of airway care to safely prevent iatrogenesis and to promote safety in patients severely affected by COVID-19, including mitigation of aerosol generation to minimize risk for health care workers.