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Abstract
COVID-19 has impacted how we deliver care to patients, and much remains unknown regarding optimal management of respiratory failure in this patient population. There are significant controversies regarding tracheostomy in patients with COVID-19 related to timing, location of procedure, and technique. In this narrative review, we explore the recent literature, publicly available guidelines, protocols from different institutions, and clinical reports to provide critical insights on how to deliver the most benefit to our patients while safeguarding the health care force. Consensus can be reached that patients with COVID-19 should be managed in a negative-pressure environment with proper personal protective equipment, and that performing tracheostomy is a complex decision that should be made through multidisciplinary discussions considering patient prognosis, institutional resources, staff experience, and risks to essential health care workers. A broad range of practices exist because there is no conclusive guidance regarding the optimal timing or technique for tracheostomy.
Footnotes
- Correspondence: Stephen S Chiang MD, University at Buffalo, The State University of New York, 100 High St, Buffalo, New York 14260–1660. E-mail: schiang3{at}buffalo.edu
Sponsored by American Association for the Surgery of Trauma International Relations Committee Funding. The authors have disclosed no conflicts of interest.
- Copyright © 2020 by Daedalus Enterprises
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