Objectives: Tracheostomy for coronavirus disease 2019 pneumonitis patients requiring prolonged invasive mechanical ventilation remains a matter of debate. This study analysed the timing and outcomes of percutaneous tracheostomy, and reports our experience of a dedicated ENT-anaesthetics department led tracheostomy team.
Method: A prospective single-centre observational study was conducted of patients undergoing tracheostomy, who had been diagnosed with coronavirus disease 2019 pneumonitis, between 21st March and 20th May 2020.
Results: Eighty-one patients underwent tracheostomy after a median (interquartile range) of 16 (13-20) days of invasive mechanical ventilation. Median follow-up duration was 32 (23-40) days. Of patients, 86.7 per cent were successfully liberated from invasive mechanical ventilation in a median (interquartile range) of 12 (7-16) days. Moreover, 68.7 per cent were subsequently discharged from hospital. On univariate analysis, there was no difference in outcomes between early (before day 14) and late (day 14 or later) tracheostomy. The mortality rate was 8.6 per cent and no deaths were tracheostomy related.
Conclusion: Outcomes appear favourable when patients are carefully selected. Percutaneous tracheostomy performed via a multidisciplinary approach, with appropriate training, was safe and optimised healthcare resource utilisation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729174 | PMC |
http://dx.doi.org/10.1017/S0022215120002303 | DOI Listing |
Intensive Care Med Exp
January 2025
Department of Pulmonary and Critical Care Medicine, University of Minnesota, St Paul, Minneapolis, MN, USA.
Andes Pediatr
October 2024
Departamento de Neuropediatría, Hospital Fundación Alcorcón, Madrid, España.
Unlabelled: Congenital myotonic dystrophy type 1 (DM1) is a rare entity that can pose a diagnostic challenge, especially if other processes such as prematurity coexist.
Objective: to describe the typical presentation of congenital DM1 and thus increase diagnostic suspicion.
Clinical Case: A 29-week preterm female newborn who required non-invasive mechanical ventilation until 41 weeks postmenstrual age; she presented with apnea requiring manual ventilation with a self-inflating bag and cardiac massage.
Andes Pediatr
October 2024
Instituto de Enfermería, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.
Unlabelled: There is evidence of the benefits that breastfeeding (BF) provides to full-term and premature newborns who are hospitalized. In the latter, maintaining BF during and after hospitalization is difficult.
Objective: To determine the factors associated with BF cessation in preterm infants one month after discharge from a neonatology unit.
Andes Pediatr
October 2024
Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile.
Viral infections are the main cause of acute respiratory failure in infants, which can progress to acute respiratory distress syndrome (ARDS), with high morbidity and mortality, so it is essential to imple ment strategies that prevent this progression. Recently, it has been proposed that increased work of breathing would not only be a warning symptom during the evolution of acute respiratory failure, but also a mechanism for the progression of injury, both lungs and diaphragm, coining the concept of patient self-inflicted lung injury. Since the first reports of ARDS, the usefulness of the use of con tinuous positive airway pressure (CPAP) has been raised, a non-invasive respiratory support therapy with wide access and low cost, capable of improving oxygenation and work of breathing.
View Article and Find Full Text PDFAndes Pediatr
August 2024
Servicio de Neonatologia, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile.
Unlabelled: Observational studies have described an increase in the duration of oxygen therapy, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP) in relation to the use of high-flow nasal cannula (HFNC, 2013-2016).
Objective: to analyze changes in the evolution of very preterm newborns with the use of HFNC.
Patients And Method: The incidence of neonatal pathologies between 2013 and 2021 was analyzed with a statistical process control.
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