Tracheostomy in patients with high suspicion or diagnosis of COVID-19: case series from two hospitals in Northwestern Mexico

Abstract

Abstract OBJECTIVE. To describe the results of tracheostomy in a series of cases in patients with COVID-19 admitted to the intensive care unit in two hospitals in the Northwest Mexico. MATERIAL AND METHODS. A prospective, descriptive, longitudinal study was carried out on a series of cases from April 2020 to August 2020. Data such as age, sex, hospital of origin, risk factors for the development of severe COVID-19, ventilatory and gasometric parameters before and 72 hours after, the days of oro-tracheal intubation were taken into account. Descriptive statistics with frequencies and percentages were used for the qualitative variables, for the numerical measures of central tendency as the mean and the median, the distribution of the results. RESULTS. From April to August 2020, in the two Intensive Care Units (ICUs) of these hospitals, 134 COVID-19 cases were admitted. In 14 patients (10.4%) tracheotomies were performed, 13 (92.8%) were male, mean age 49.21 years, 85% tested positive. The mean duration of oro-tracheal intubation was 22.7. Obesity combined with diabetes and arterial hypertension represented a risk factor in 57.1% of the cases. In 10 patients, the procedure was performed in the ICU bed. There were changes in some ventilatory parameters before and 72 hours after the procedure. The average number of days after weaning from the ventilator was 5.5 days. There were 3 deaths in our series. CONCLUSION. The adequate and prudent selection of COVID-19 patients for tracheostomy makes it easier to choose with greater justification the patients with the best prognosis, avoiding unnecessary procedures in a patient and a greater risk of contagion in the personnel.