Journal of Surgery

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Research Article |

Tracheostomy in Critically Ill Patients Due to COVID-19 Before the Vaccine, Cases and Controls

Objective: This study aims to identify factors associated with death in seriously ill patients with SARS CoV-2 pneumonia who required a tracheostomy and the time in which the procedure was performed. Patients and methods: The study was observational, analytical, prospective, cross-sectional, and case-control in nature. The decision to perform a tracheostomy was based on the clinical conditions and the approval of the Institutional COVID Committee. To compare means of continuous numerical variables, paired and unpaired Student's t test was used depending on the variables analyzed; to establish correlation between continuous numerical variables, the Pearson correlation coefficient was calculated; to analyze the probability of death with respect to the variables studied, the odds ratio was calculated with a 95% compatibility interval. Results: a total of 47 severely ill patients with COVID-19, who were admitted to the Intensive Care Unit, and required a tracheostomy, 17 women and 30 men, underwent an open tracheostomy. The population was predominantly male, and blood type A+ was more common. Most of them had at least one of the following comorbidities: Diabetes, hypertension, obesity or smoke. Only 10 patients survived until the end of following. All tracheostomies were performed in the first days of the illness, even in the first seven days, except for one patient. All tracheostomies were performed openly, almost all within a conventional operating room and performed by General Surgeons; We have not had any early or late complications, although the risk of tracheal stenosis remains latent; none of the surgeons presented symptoms of the disease, although detection test were never applied to us. Conclusion: In this group of patients, diabetes, systemic arterial hypertension, obesity, blood type "A" and age over 65 years were associated with higher mortality, while no improvement was shown when tracheostomy was performed early, even the first 7 days.

COVID-19, Tracheostomy in COVID, Early Tracheostomy, Cases and Controls, Pandemic, COVID Risk

APA Style

María Norma Gómez Herrera, Aurora García Gómez, María Enriqueta Baridó Murguía, Jaime Carranza Madrigal, Lizbeth Corzo Aguilar, et al. (2023). Tracheostomy in Critically Ill Patients Due to COVID-19 Before the Vaccine, Cases and Controls . Journal of Surgery, 11(5), 113-118. https://doi.org/10.11648/j.js.20231105.15

ACS Style

María Norma Gómez Herrera; Aurora García Gómez; María Enriqueta Baridó Murguía; Jaime Carranza Madrigal; Lizbeth Corzo Aguilar, et al. Tracheostomy in Critically Ill Patients Due to COVID-19 Before the Vaccine, Cases and Controls . J. Surg. 2023, 11(5), 113-118. doi: 10.11648/j.js.20231105.15

AMA Style

María Norma Gómez Herrera, Aurora García Gómez, María Enriqueta Baridó Murguía, Jaime Carranza Madrigal, Lizbeth Corzo Aguilar, et al. Tracheostomy in Critically Ill Patients Due to COVID-19 Before the Vaccine, Cases and Controls . J Surg. 2023;11(5):113-118. doi: 10.11648/j.js.20231105.15

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. David Ziehr, Jehan Alladina, Camille Petri, Jason Maley, Ari Mozkowitz, Benjamin Medoff, Katryn Hibbert, Taylor Thompson & Corey Hardin. (2020) Respiratory pathophysiology of mechanically ventilated patients with COVID-19: a cohort study. American Journal of Respiratory and Critical Care Medicine (201) doi: 10.1164/rccm.202004-1163LE.
2. Safiya Richardson, Jamie Hirsch & Mangala Narasimhan. (2020). Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID- 19 in the New York City area. JAMA (23). doi: 10.1001/jama.2020.6775.
3. Wei-Jie Guan, Zeng Yi Ni, Yu Hu, Wen-hua Liang, Chun-quan Ou, Jian-xing He, Lei Liu, Hong Shan, Chun-liang Lei, David S. C. Hui, Bin Du & Lan-juan. (2020) Clinical characteristics of coronavirus disease 2019 in China. The New England Journal of Medicine (382). doi: 10.1056/NEJMoa2002032.
4. Feng He, Yu Deng & Weina Li (2020). Coronavirus Disease 2019 (COVID-19): What we know? Journal of Medical virology 92 (7). doi: 10.1002/jmv.25766.
5. Carlos M Chiesa-Estomba, Jérome R. Lechien, Christian Calvo-Henríquez, Nicolas Fakhry, Petros D Karkos, Shazia Peer, Jon A. Sistiaga-Suarez, JoséA. Gónzalez-García, Giovanni Cammaroto, Miguel Mayo-Yánez, Pablo Parente-Arias, Sven Saussez, &Tareck Ayad. (2020). Systematic review of international guidelines for tracheostomy in COVID-19 patients. Oral Oncology (108) 104844. doi.org/10.1016/j.oraloncology.2020.104844.
6. Tiffany N Chao, Benjamin Braslow, Niels D Martin, Ara Chalian, J. Atkins, Andrew R Haas & Christopher Rassekh. (2020) Guidelines from the COVID-19 Tracheotomy Task Force, a Working Group of the Airway Safety Committee of the University of Pennsylvania Health System. Wolters Kluwer Health. Annals of Surgery 272 (1) doi: 10.1097/SLA.0000000000003956.
7. Arunjit Takjar, Abigail Walker, Stephen Tricklebank, Duncan Wyncoll, Nicholas Hart, Tony Jacob, Asit Arora, Christopher Skilbeck, Ricard Simo & Pavol Surda. (2020) Recommendation of a practical guideline for safe tracheostomy during the COVID‐19 pandemic. European Archives of Oto-Rhino-Laryngology (277). doi: 10.1007/s00405-020-05993-x.
8. Damian Broderick, Panayiotis Kyzas, Andrew Baldwin, Richard Graham, Tracy Duncan, Christos Chaintoutis, Evangelos Boultoukas & Leandros Vassiliou. (2020) Surgical tracheostomies in COVID- 19 patients: a multidisciplinary approach and lessons learned. Oral Oncology. (15) doi: 10.1016/j.oraloncology.2020.104767.
9. Brendan McGrath, Michael Brenner M, Stephen Warrillow, Vinciya Pandian, Asit Arora &Tanis Cameron (2020) Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. wwwthelancet.com/respirator. May (15). doi: 10.1016/S2213-2600(20)30230-7.
10. John C. Lee, & Mitchell P. Fink. (2005) A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Critical Care 32 (8) doi: 10.1097/01.ccm.0000134835.05161.b6.
11. Tiffany Chao, Sean Harbinson, Benjamin Braslow, Christoph Hutchinson, Karthik Rajasekaran, Beatrice Go,, Elle A Paul, Leah Lambe, James Kearney, Ara Chalian, Maurizio Cereda, Niels Martin, Andrew Haas, Joshua & Christopher Rassekh. (2020). Outcomes After Tracheostomy in COVID-19 Patients. Annals of Surgery 272. doi: 10.1097/SLA.0000000000004166.
12. Hamilton (2020) COVID Trach; the out- comes of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK: British Journal of Surgery 107 (12). doi: 10.1002/bjs.12020.
13. Vicenzo Russotto, Sheila Nainan Myatra & John Laffey. (2021) Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries; JAMA 325 (12). doi: 10.1001/jama.2021.1727.
14. Kamran Mahmood, George Cheng, Kerian Van Nostrand K, Samira Shojaee, Max Wayne, Matthew Abbott, Darrell Nettlow, Alice Parish, Cynthia Green, Javeryah Safi & Michael Brenner. (2021) Tracheostomy for COVID-19 Respiratory Failure Multidisciplinary, Multicenter Data on Timing, Technique, and Outcomes; Annals of Surgery 274, (2). doi: 10.1097/SLA.0000000000004955.
15. Freeman, Bradley D, Isabella, Karen RN, Perren Cobb, Boyle, Walter A, Schmieg, Robert E. Jr, Kolleff, Marin H, Lin, Natatia, Saak, Thomas Thompson, Errington C, Buchman &Timothy G. (2001). A prospective, randomized study comparing percutaneous with surgical tracheostomy in critically ill patients. Critical Care Medicin (29). doi: 10.1097/00003246-200105000-00002.
16. Carol Bowen, Larry Whitney, Jonathon Truwit, Charles Durbin, & Marcia Moore. (2001). Comparison of safety and cost of percutaneous versus surgical tracheostomy. The American Surgeon (67). PMID: 11206898.
17. Lukas Fischler, Stefan Erhart, Gian Reto Kleger & Adrian Frutiger. (2000). Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland. Intensive Care Medicine (26). doi: 10.1007/s001340000634.
18. Dave Dongelmans, Ari Jan Van der Lely, Robert Tepaske & Marcus Schultz, (2004) Complications of percutaneous dilating tracheostomy. Critical Care (8). doi 10.1186/cc2941.
19. Bernard Fikkers, Niels van Heerbeek, Paul Krabbe, Henri Marres & Frank Van den Hoogen. (202) Percutaneous tracheostomy with the guide wire dilating forceps technique: presentation of 171 consecutive patients. Journal of the Sciences and Spelcialtes of the Head and Neck (24) doi.org/10.1002/hed.10113.
20. PM Reilly, RF Sing, FA Giberson, HL Anderson, MF Rotondo, GH Tinkoff & CW Schwab.(1997). Hypercarbia during tracheostomy: a comparison of percutaneous endoscopic, percutaneous Doppler, and stan- dard surgical tracheostomy. Intensive Care Medicine (23) doi: 10.1007/s001340050422.
21. Rosa Klotz, Pascal Probst, Marlene Deininger, Ulla Klaiber, Kathrin Grummich, Markus Diener, Markus Weigand, Markus Buchler & Phillip Knebel. (2018) Percutaneous versus surgical strategy for tracheostomy: a systematic review and meta-analysis of perioperative and postoperative complications. Langenbeck´s Archives Of Surgery (403). doi: 10.1007/s00423-017-1648-8.
22. Cecilia Bottia, Francesca Lusettib, Tommaso Neri, Stefano Peroni, Andrea Castellucci, Pierpaolo Salsi & Angelo Ghidini. (2021) Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits; Auris Nasus Larynx (48) doi.org/10.1016/j.anl.2020.10.014.
23. Li Ran, Xuyu Chen & Ying Wang, (2020) Risk Factors of Healthcare Workers with Coronavirus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clinical infectious Diseases 71 (16). doi: 10.1093/cid/ciaa287.
24. Mattew Weaver, Christopher Landrigan, Jason Sullivan, Conor Obrien, Salim Qadri, Natalie Viyaran, Wei Wang, Céline Vetter, Charles Czeisler & Laura Barger. (2020). The association between resident physician work hour regulations and physician safety and health. The American Journal of Medicine 133 (7) doi: 10.1016/j.amjmed.2019.12.053.
25. Alexander Obukhov, Bruce Stevens, Ram Prasad, Sergio Li Calzi, S., Michael Boulton, Mohan Raizada, Gavin Oudit & Maria Grant. (2020). SARS-CoV-2 Infections and ACE2: Clinical Outcomes Linked with Increased Morbidity and Mortality in Individuals With Diabetes. Diabetes (69). doi. org/10.2337/dbi20-0019.
26. Molly Fisher, Joel Neugarten, Eran Bellin, Milagros Yunes, Lindsay Stahl, L., Tanya Johns, Mattew Abramowitz, Rebecca Levy, Neelja Kumar, Michele Mokrzycki, Maria Coco, Mary Dominguez, Kalyan Prudhvi, & Ladan Golestane. (2020). AKI in Hospitalized Patients with and without COVID-19: A Comparison Study. Journal of the American Society of Nefrology (31). doi.org/10.1681/ ASN.2020040509.
27. Yaquian Duan, Ram Prasad, Dogni Feng, Eleni Beli, Sergio Li Calzi, Ana Leda Longhini, Regina Lamendella, Jason Floyd, Mariana Dupont & Sunil Noothi,(2019). Bone Marrow-Derived Cells Restore Functional Integrity of the Gut Epithelial and Vascular Barriers in a Model of Diabetes and ACE2 Deficiency. Circulation Research (125). doi.org/10.1161/CIRCRESAHA.119. 315743.
28. Vaibhab Patel, Jun Mori, Brent McLean, Ratnadeep Basu, Subhash Das, Tharmarajan Ramprasath, Nirmal Parajuli, Josef Penninger, Maria Grant, Gary Lopaschuk, & Gavin Oudit, (2016). ACE2 Deficiency Worsens Epicardial Adipose Tissue Inflam- mation and Cardiac Dysfunction in Response to Diet-Induced Obesity. Diabetes (65) https://doi.org/10.2337/db15-0399.
29. ST Ngo, FJ Steyn, & PA McCombe, (2014) Gender differences in autoimmune disease. Frontiers in Neuroendocrinology. (35) doi: 10.1016/j.yfrne.2014.04.004.
30. Michael Butterworth, Barbara McClellan & Mathea Aklansmith. (1967) Influence of sex in immunoglobulin levels. Nature (214) doi: 10.1038/2141224a0.
31. Philip Staibano, Shahzaib Khattak, Faisan Amin, Paul Engels, Doron Sommer (2023). Tracheostomy in Critically Ill COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Single-Center Experience. Annals of Otology, Rhinology and Laryngology, abril 2023. https://doi.org/10.1177/00034894231166648
32. Mohamed Tayeb Salaouatchi, Linda Spinato, Said Sanoussi, Maria Do Carmo Filomena Mesquita. (2023) Respirology Case Reports (11). https://doi.org/10.1002/rcr2.1127
33. Serena Conforti, GloriaLicchetta, Marco Reda, Arash Astaneh Luca Pogliani, Stefano Fieschi, Alessandro Rinaldo, Massimo Torre. (2023) Management of COVID-19-related post-intubation tracheal stenosis. Perspective in Surgery (10) | https://doi.org/10.3389/fsurg.2023.1129803
34. Gabriele Molteni, Virginia Dallari, Erika Segato, Francesco Mattioli, (2023). The Laryngoscope, (00) https://www.researchgate.net/profile/Virginia-Dallari-
35. Ricardo Orlandi, Federico Raveglia, Matteo Calderoni, Enrico Mario Cassina, Ugo Cioffi, Angelo Tuoro, Eliseo Passera. (2023). Management of COVID-19 related tracheal stenosis: The state of art. Thoracic Surgery (10). https://doi.org/10.3389/fsurg.2023.1118477
36. Catherine Roy, Jennifer Silver, Sena Turkdogan (2023). Complication Rate of Percutaneous Dilatational (2023). Complication Rate of Percutaneous Dilatational Tracheostomy in Critically Ill Adults with Obesity A Systematic Review and Meta-analysis. JAMA Otolaryngology Head and Neck Surgery 149 (4). doi: 10.1001/jamaoto.2022.4824.
37. Giuseppe Mangiameli, Gianluca Perroni, Andrea Constantino, Armando De Virgilio, Luca Malvezzi Giuseppe Mercante, Veronica Maria Giudici, Giorgio Maria Ferraroli, Emanuele Voulaz. (2023). Analysis of RiskFactors For Tracheal Stenosis Managed during COVID-19 Pandemic: A Retrospective, Case control Study from Two European Referral CentreJournal of Personalized Medicine 13 (5). https://doi.org/10.3390/jpm13050729.