Levent AYDEMİR, Hakan KARA, Cömert ŞEN, Kadir ORHAN, Meryem Nesil KELEŞ TÜREL

COVID-19 HASTALARINDA MEKANİK VENTİLASYONDAN AYRILMADA TRAKEOTOMİNİN ROLÜ

Amaç: COVID-19 hastalarının önemli bir kısmına, tedavileri sırasında invazif mekanik ventilasyon desteği gerekir. Uzun süreli mekanik ventilasyon, bu hastaların bazılarında trakeotomi ihtiyacını ortaya çıkarır. Çalışmada, COVID-19 hastalarında trakeotominin olası faydalarını ve klinik sonuçlar üzerindeki etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Kurumumuzda açık trakeotomi yapılan altı adet COVID-19 hastası retrospektif olarak incelendi. Trakeotomi işlemleri sırasında güvenlik önlemlerinin etkinliği, kişisel koruyucu ekipman (KKE) kullanımı ve işlemin prognoza etkisi değerlendirildi. Bulgular: Trakeotomi öncesi ortalama entübasyon süresi 21 gündü (aralık, 14-28). Tüm hastalar erkekti ve ortalama yaş 62 idi. Hastaların beşi ameliyat sonrası dönemde öldü. Bir hasta taburcu edildi ve dekanüle edildi. İşlemlerden sonra havayolu ekibinin hiçbir üyesi enfekte olmadı. Sonuç: COVID-19 hastalarında trakeotomi, uygun KKE önlemleri alındığında güvenli bir işlemdir. Verilerimiz, COVID-19’lu hastalarda trakeotominin hastaları mekanik ventilatörden ayırmayı kolaylaştırdığını desteklemedi.

Anahtar Kelimeler:

COVID-19, Trakeotomi, Mekanik ventilasyon

THE ROLE OF TRACHEOTOMY IN WEANING FROM MECHANICAL VENTILATION IN PATIENTS WITH COVID-19

Objective: Significant numbers of COVID-19 patients require invasive mechanical ventilation support during their treatment. Prolonged mechanical ventilation causes a tracheotomy need in some of those patients. The study aimed to assess the possible benefits of tracheotomy in patients with COVID-19 and its effect on clinical outcomes. Material and Method: Six patients with COVID-19 who underwent an open tracheotomy in our institution were retrospectively reviewed. Its effect on the prognosis, the effectiveness of the safety precautions, and personnel protective equipment (PPE) utilization during the tracheotomy procedures was evaluated. Results: Mean intubation period before a tracheotomy was 21 days (range,14-28). All patients were male with a mean age of 62. Five of them died postoperatively. One patient was discharged and decannulated. None of the airway team members were infected after the procedures. Conclusion: Tracheotomy in COVID-19 patients is a safe procedure when appropriate PPE measures are taken. Our data do not support the contribution of tracheotomy to accelerating ventilator weaning in patients with COVID-19.

Keywords:

COVID-19, Tracheotomy, Mechanical ventilation,

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