Practice of tracheostomy in patients with acute respiratory failure related to COVID–19 – Insights from the PRoVENT–COVID study
Issued Date
2022-01-01
Resource Type
ISSN
25310429
eISSN
25310437
Scopus ID
2-s2.0-85119916596
Pubmed ID
34836830
Journal Title
Pulmonology
Volume
28
Issue
1
Start Page
18
End Page
27
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pulmonology Vol.28 No.1 (2022) , 18-27
Suggested Citation
Tsonas A.M. Practice of tracheostomy in patients with acute respiratory failure related to COVID–19 – Insights from the PRoVENT–COVID study. Pulmonology Vol.28 No.1 (2022) , 18-27. 27. doi:10.1016/j.pulmoe.2021.08.012 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86731
Title
Practice of tracheostomy in patients with acute respiratory failure related to COVID–19 – Insights from the PRoVENT–COVID study
Author(s)
Author's Affiliation
Amsterdam Neuroscience
Manchester University NHS Foundation Trust
Hogeschool van Amsterdam, University of Applied Sciences
University of Michigan Medical School
Monash University
Icahn School of Medicine at Mount Sinai
Mahidol University
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Global Tracheostomy Collaborative
Manchester University NHS Foundation Trust
Hogeschool van Amsterdam, University of Applied Sciences
University of Michigan Medical School
Monash University
Icahn School of Medicine at Mount Sinai
Mahidol University
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Global Tracheostomy Collaborative
Other Contributor(s)
Abstract
Objective: Invasively ventilated patients with acute respiratory failure related to coronavirus disease 2019 (COVID–19) potentially benefit from tracheostomy. The aim of this study was to determine the practice of tracheostomy during the first wave of the pandemic in 2020 in the Netherlands, to ascertain whether timing of tracheostomy had an association with outcome, and to identify factors that had an association with timing. Methods: Secondary analysis of the ‘PRactice of VENTilation in COVID–19’ (PRoVENT–COVID) study, a multicenter observational study, conducted from March 1, 2020 through June 1, 2020 in 22 Dutch intensive care units (ICU) in the Netherlands. The primary endpoint was the proportion of patients receiving tracheostomy; secondary endpoints were timing of tracheostomy, duration of ventilation, length of stay in ICU and hospital, mortality, and factors associated with timing. Results: Of 1023 patients, 189 patients (18.5%) received a tracheostomy at median 21 [17 to 28] days from start of ventilation. Timing was similar before and after online publication of an amendment to the Dutch national guidelines on tracheostomy focusing on COVID–19 patients (21 [17–28] vs. 21 [17–26] days). Tracheostomy performed ≤ 21 days was independently associated with shorter duration of ventilation (median 26 [21 to 32] vs. 40 [34 to 47] days) and higher mortality in ICU (22.1% vs. 10.2%), hospital (26.1% vs. 11.9%) and at day 90 (27.6% vs. 14.6%). There were no patient demographics or ventilation characteristics that had an association with timing of tracheostomy. Conclusions: Tracheostomy was performed late in COVID–19 patients during the first wave of the pandemic in the Netherlands and timing of tracheostomy possibly had an association with outcome. However, prospective studies are needed to further explore these associations. It remains unknown which factors influenced timing of tracheostomy in COVID–19 patients.