Carol Bier-LaningJohn D. CramerSoham RoyPatrick A. PalmieriAyman AminJosé Manuel AñonCesar A. Bonilla-AsaldePatrick J. BradleyPankaj ChaturvediDavid M. CognettiFernando DiasArianna Di StadioJohannes J. FaganDavid J. Feller-KopmanSheng Po HaoKwang Hyun KimPetri KoivunenWoei Shyang LohJobran MansourMatthew R. NaunheimMarcus J. SchultzYou ShangDavud B. SirjaniMaie A. St. JohnJoshua K. TaySébastien VergezHeather M. WeinreichEddy W.Y. WongJohannes ZenkChristopher H. RassekhMichael J. BrennerSchool of MedicineHospital Nacional Daniel Alcides CarriónUniversidad Privada San Juan BautistaUniversidad Norbert WienerUniversity of Michigan Medical SchoolStanford University School of MedicinePontifícia Universidade Católica do Rio de JaneiroNUS Yong Loo Lin School of MedicineUniversity of Illinois College of MedicineUniversity of Texas Medical School at HoustonShin-Kong Wu Ho-Su Memorial Hospital TaiwanWayne State University School of MedicineTata Memorial HospitalLoyola University Medical CenterNational University of SingaporeOulu University HospitalThomas Jefferson UniversityUniversity of NottinghamMahidol UniversityChaim Sheba Medical Center IsraelCairo UniversityNuffield Department of MedicineHôpital RangueilUniversity of PennsylvaniaDavid Geffen School of Medicine at UCLAMassachusetts Eye and Ear InfirmaryUniversità degli Studi di PerugiaChinese University of Hong KongUniversidad Carlos III de MadridTongji Medical CollegeAmsterdam UMC - University of AmsterdamJohns Hopkins School of MedicineSeoul National University College of MedicineUniversity of Cape TownEvidence-Based Health Care South America: A Joanna Briggs Institute Affiliated GroupGlobal Tracheostomy CollaborativeUniversitätsklinikum Augsburg Klinik für HNO-Heilkunde2022-08-042022-08-042021-06-01Otolaryngology - Head and Neck Surgery (United States). Vol.164, No.6 (2021), 1136-114710976817019459982-s2.0-85094954908https://repository.li.mahidol.ac.th/handle/20.500.14594/78190Objective: The coronavirus disease 2019 (COVID-19) pandemic has led to a global surge in critically ill patients requiring invasive mechanical ventilation, some of whom may benefit from tracheostomy. Decisions on if, when, and how to perform tracheostomy in patients with COVID-19 have major implications for patients, clinicians, and hospitals. We investigated the tracheostomy protocols and practices that institutions around the world have put into place in response to the COVID-19 pandemic. Data Sources: Protocols for tracheostomy in patients with severe acute respiratory syndrome coronavirus 2 infection from individual institutions (n = 59) were obtained from the United States and 25 other countries, including data from several low- and middle-income countries, 23 published or society-endorsed protocols, and 36 institutional protocols. Review Methods: The comparative document analysis involved cross-sectional review of institutional protocols and practices. Data sources were analyzed for timing of tracheostomy, contraindications, preoperative testing, personal protective equipment (PPE), surgical technique, and postoperative management. Conclusions: Timing of tracheostomy varied from 3 to >21 days, with over 90% of protocols recommending 14 days of intubation prior to tracheostomy. Most protocols advocate delaying tracheostomy until COVID-19 testing was negative. All protocols involved use of N95 or higher PPE. Both open and percutaneous techniques were reported. Timing of tracheostomy changes ranged from 5 to >30 days postoperatively, sometimes contingent on negative COVID-19 test results. Implications for Practice: Wide variation exists in tracheostomy protocols, reflecting geographical variation, different resource constraints, and limited data to drive evidence-based care standards. Findings presented herein may provide reference points and a framework for evolving care standards.Mahidol UniversityMedicineReviewSCOPUS10.1177/0194599820961985