TRACHEOSTOMY AND TRACHEOSTOMY CARE DURING THE COVID-19 PANDEMIC

Covid-19 pandemic is a global health problem that affects the whole world and can progress with asymptomatic or viral symptoms of pneumonia or cause severe acute respiratory failure. SARS-CoV-2 has spread much more widely and quickly than other viruses and has caused a significant number of life losses globally. Tracheostomy is a surgical procedure that is frequently performed by ENT and head & neck surgeons with various indications, and its implementation can facilitate weaning patients from mechanical ventilation, thereby potentially increasing the availability of beds in the intensive care unit (ICU). Since tracheostomy causes a large amount of aerosol formation, it is a serious risk process for the spread of covid-19 infection even if personal protective equipment (PPE) is used both during surgery and postoperative care. There is not enough experience on how to perform tracheotomy in Covid-19 patients. Therefore, the surgical procedure and indications for tracheostomy should be revised during the covid-19 pandemic process. We aim to provide authoritative guidance for healthcare providers and healthcare systems by synthesizing our experience with tracheostomy, available evidence, and information in the literature data during the current COVID-19 pandemic.

COVİD-19 Pandemisi Sırasında Trakeostomi ve Trakeostomi Bakımı

Covid-19 pandemisi tüm dünyayı etkisi altına alan, asemptomatik veya viral pnömoni semptomlarıyla seyredebileceği gibi ciddi akut solunum yetmezliğine de neden olabilen global bir sağlık problemidir. SARS-CoV-2, diğer virüslerden çok daha geniş ve hızlı bir şekilde yayılmıştır ve küresel olarak ciddi sayıda hayat kaybına yol açmıştır. Trakeostomi, KBB ve baş-boyun cerrahları tarafından çeşitli endikasyonlarla sıkça gerçekleştirilen cerrahi bir prosedürdür ve bu prosedürün uygulanması hastaları mekanik ventilasyondan ayırmayı kolaylaştırabilir ve böylece yoğun bakım ünitesindeki (YBÜ) yatakların kullanabilirliğini potansiyel olarak artırabilir. Trakeostomi yüksek miktarda aerosol oluşumuna neden olduğu için hem cerrahi sırasında hem de cerrahi sonrası bakım sırasında kişisel koruyucu ekipman (KKE) kullanılsa bile covid-19 enfeksiyonu yayılımı için ciddi risk oluşturan bir işlemdir. Covid-19 hastalarında trakeotominin nasıl yapılması gerektiği konusunda yeterli deneyim mevcut değildir. Bu yüzden covid-19 pandemisi sürecinde trakeostomi cerrahi prosedürü ve endikasyonları yeniden gözden geçirilmelidir. Mevcut COVID-19 pandemisi sırasında trakeostomi ile ilgili deneyimlerimizi, mevcut kanıtları ve literatürdeki bilgileri sentezleyerek sağlık hizmeti sağlayıcıları ve sağlık sistemleri için yetkili rehberlik sağlamayı amaçlıyoruz.

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