Safe and Efficient Performance of Open Tracheostomies in Patients with COVID-19 - The Fenestrated Technique

Document Type

Letter to the Editor

Publication Date

1-21-2021

Publication Title

JAMA Otolaryngology-Head and Neck Surgery

First page number:

301

Last page number:

302

Abstract

Tracheostomy plays an important role in ventilated patients by improving pulmonary toileting and ventilator weaning while reducing risks of airway stenosis from prolonged intubation. However, it is associated with a considerable aerosolization risk.1,2 Severe acute respiratory syndrome coronavirus 2, which is responsible for coronavirus disease 2019 (COVID-19), concentrates in the upper aerodigestive tract and is transmitted through droplets or aerosols from aerosol-generating procedures (AGPs) performed in this region.3 While these facts have driven recommendations for using negative-pressure rooms and higher-grade personal protective equipment, such as powered air-purifying respirators for AGPs,4,5 there has not been a published study specifically investigating a technique of open tracheostomy that could further reduce aerosolization risks and improve safety. We demonstrate a fenestrated technique of tracheostomy that minimizes aerosolization risks by reducing risk of accidental decannulation and stomal infections while creating a tight seal around the tracheostomy tube.

Disciplines

Surgical Procedures, Operative

Language

English

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