Background: SARS-CoV-2 can cause severe respiratory failure leading to prolonged mechanical ventilation. Data are just emerging about the practice and outcomes of tracheostomy in these patients. We reviewed our experience with tracheostomies for SARS-CoV-2 at our tertiary-care, urban teaching hospital.
Methods: We reviewed the demographics, comorbidities, timing of mechanical ventilation, tracheostomy, and ICU and hospital lengths-of-stay (LOS) in SARS-CoV-2 patients who received tracheostomies. Early tracheostomy was considered <14 days of ventilation. Medians with interquartile ranges (IQR) were calculated and compared with Wilcoxon rank sum, Spearman correlation, Kruskal-Wallis, and regression modeling.
Results: From March 2020 to January 2021, our center had 370 patients intubated for SARS-CoV-2, and 59 (16%) had percutaneous bedside tracheostomy. Median time from intubation to tracheostomy was 19 (IQR 17 - 24) days. Demographics and comorbidities were similar between early and late tracheostomy, but early tracheostomy was associated with shorter ICU LOS and a trend towards shorter ventilation. To date, 34 (58%) of patients have been decannulated, 17 (29%) before hospital discharge; median time to decannulation was 24 (IQR 19-38) days. Decannulated patients were younger (56 vs 69 years), and in regression analysis, pneumothorax was associated was associated with lower decannulation rates (OR 0.05, 95CI 0.01 - 0.37). No providers developed symptoms or tested positive for SARS-CoV-2.
Conclusions: Tracheostomy is a safe and reasonable procedure for patients with prolonged SARS-CoV-2 respiratory failure. We feel that tracheostomy enhances care for SARS-CoV-2 since early tracheostomy appears associated with shorter duration of critical care, and decannulation rates appear high for survivors.
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http://dx.doi.org/10.1101/2021.02.23.21252231 | DOI Listing |
Riga-Fede disease (RFD) is a rare, benign condition marked by traumatic ulceration on the tongue's ventral side in infants. It arises from friction between the tongue and lower incisors during sucking, potentially worsening into a keratinized lesion if the cause is not addressed. This report details the case of a 1-year-6-month-old male with hydrocephalus, cleft palate, corpus callosum dysgenesis, neuropsychomotor developmental delay, and tracheostomy and gastrostomy needs.
View Article and Find Full Text PDFClin Transplant
February 2025
Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Background: Invasive Candida infections (ICI) are the most common invasive fungal infections in solid organ transplant recipients. There are limited contemporary data on the risk factors for infection in heart transplant (HT) recipients especially since the expansion of temporary mechanical circulatory support (MCS) use.
Methods: This was a case-control study conducted at a tertiary care academic hospital of HT recipients from January 2022 to January 2024.
J Dent Sci
January 2025
Department of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Background/purpose: One of the causes of ventilator-associated pneumonia (VAP) is aspiration of oropharyngeal fluid containing pathogenic microorganisms into the lower respiratory tract. In this study, we aimed to investigate whether antibiotic ointment applied to the oral cavity can reduce the number of bacteria in the fluid on the cuff of a tracheal cannula.
Materials And Methods: Tetracycline ointment was applied intraorally once to a patient under endotracheal intubation by postoperative tracheostomy for oral cancer.
Cureus
December 2024
Anesthesiology and Critical Care, Faculty of Medicine, University of Banja Luka, Banja Luka, BIH.
Cervical plexus block (CPB), like other types of regional anesthesia, represents an alternative anesthetic technique in those cases where the performance of general anesthesia (GA) carries an increased risk both for the patient and the outcome of the operative treatment. It has traditionally been used for years in carotid surgery as an alternative to GA, especially due to the possibility of superior monitoring - the awake patient. However, its effectiveness has been proven in other types of neck surgery, primarily in thyroid surgery, neck dissections, tracheostomy, central venous catheter insertion, clavicle surgery, etc.
View Article and Find Full Text PDFTrauma Case Rep
February 2025
Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Universitas, Indonesia.
Introduction: The prevalence of maxillofacial fractures is rising due to increased road traffic accidents, necessitating prompt and effective management, especially in cases of panfacial fractures. The primary objective in treating such fractures is to restore occlusion and stabilize midface buttresses and pillars.
Case Report: This article presents the case of a 56-year-old male who sustained panfacial fractures following a road accident, exhibiting symptoms including facial pain and nosebleeds.
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