Tracheostomy Performed by a Head and Neck Surgeon Under the Supervision of an Intensive Care Unit Specialists in the COVID-19 Era: A Retrospective Analysis

Abstract

Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist.Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period.Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients.Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.