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Purpose <p>To compare early vs. late tracheostomy outcomes in Ventilated COVID19 patients.</p> Methods <p>We retrospectively assessed patients admitted to the ICU with COVID-19 pneumonitis from March 2020 until March 2022 who underwent tracheostomy. Data were collected by reviewing the electronic medical records and included demographics (age, sex, body mass index, and nationality), comorbidities, mode of ventilation prior to tracheostomy, time needed for the procedure, extracorporeal membrane oxygenation, outcome of patient and if complications reported. A P-value ˂ 0.05 was considered statistically significant. The data was analyzed using SPSS Statistics for Windows, version 25.0.</p> Results <p>A total of 39 patients were included in the analysis. The mean age was 57.82 ± 12.79. The mean of lowest PaO2 was 76.72 ± 21.86. Most patients had comorbidities (71.8%), and the most common comorbidities were diabetes mellitus (38.5%), hypertension (51.3%) or dyslipidemia (23.1%). The mode of ventilation prior to procedure was volume control in the majority of patients (87.2%) as well as CPAP in 12.8% of patients. Extracorporeal membrane oxygenation (ECMO) was done only to four patients. The average days between intubation and tracheostomy was 14.64 ± 7.3 with a median (IQR) 12 (10, 18). The patients were classified into two groups; early tracheostomy (<i>N</i> = 22) and late tracheostomy (<i>N</i> = 17). There were no statistically significant differences (<i>P</i> &gt; 0.05) in baseline characteristics between the two groups. There is no Post-Procedure Complications in the most of patients (97.4%) while only one patient had bleeding. There is no statistical difference in the duration of the tracheostomy in FICU (<i>P</i> = 0.967) between the early tracheostomy group (&lt; 10 days) and the late tracheostomy group (&gt; 10 days). None of the complications and outcomes were significantly associated with the timing of the tracheostomy (<i>P</i> &gt; 0.05). The overall mortality rate was 38.5%.</p> Conclusions <p>We recommend that selected patients with COVID-19 pneumonitis who are intubated and showing signs of clinical improvement undergo early tracheostomy as they have better outcomes. Early tracheostomy, when done with safety precautions, is safe.</p>

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Outcome of Early Vs. Late Tracheostomy in Ventilated Covid- 19 Patients: A Retrospective Study

  • 期刊论文

  • 发表日期：

    2025年7月16日

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  • Saleh Alwasil,
  • Mubarak Aldoseri,
  • Jalal Alkhan,
  • Mai Nasser,
  • Mohamed Alshehabi

摘要

Purpose

To compare early vs. late tracheostomy outcomes in Ventilated COVID19 patients.

Methods

We retrospectively assessed patients admitted to the ICU with COVID-19 pneumonitis from March 2020 until March 2022 who underwent tracheostomy. Data were collected by reviewing the electronic medical records and included demographics (age, sex, body mass index, and nationality), comorbidities, mode of ventilation prior to tracheostomy, time needed for the procedure, extracorporeal membrane oxygenation, outcome of patient and if complications reported. A P-value ˂ 0.05 was considered statistically significant. The data was analyzed using SPSS Statistics for Windows, version 25.0.

Results

A total of 39 patients were included in the analysis. The mean age was 57.82 ± 12.79. The mean of lowest PaO2 was 76.72 ± 21.86. Most patients had comorbidities (71.8%), and the most common comorbidities were diabetes mellitus (38.5%), hypertension (51.3%) or dyslipidemia (23.1%). The mode of ventilation prior to procedure was volume control in the majority of patients (87.2%) as well as CPAP in 12.8% of patients. Extracorporeal membrane oxygenation (ECMO) was done only to four patients. The average days between intubation and tracheostomy was 14.64 ± 7.3 with a median (IQR) 12 (10, 18). The patients were classified into two groups; early tracheostomy (N = 22) and late tracheostomy (N = 17). There were no statistically significant differences (P > 0.05) in baseline characteristics between the two groups. There is no Post-Procedure Complications in the most of patients (97.4%) while only one patient had bleeding. There is no statistical difference in the duration of the tracheostomy in FICU (P = 0.967) between the early tracheostomy group (< 10 days) and the late tracheostomy group (> 10 days). None of the complications and outcomes were significantly associated with the timing of the tracheostomy (P > 0.05). The overall mortality rate was 38.5%.

Conclusions

We recommend that selected patients with COVID-19 pneumonitis who are intubated and showing signs of clinical improvement undergo early tracheostomy as they have better outcomes. Early tracheostomy, when done with safety precautions, is safe.