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Tracheotomy in COVID-19 Patients: A Systematic Review and Meta-analysis of Weaning, Decannulation, and Survival.
Benito, Daniel A; Bestourous, Daniel E; Tong, Jane Y; Pasick, Luke J; Sataloff, Robert T.
Afiliación
  • Benito DA; Division of Otolaryngology-Head & Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Bestourous DE; Division of Otolaryngology-Head & Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Tong JY; Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
  • Pasick LJ; Department of Otolaryngology-Head & Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Sataloff RT; Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Otolaryngol Head Neck Surg ; 165(3): 398-405, 2021 09.
Article en En | MEDLINE | ID: mdl-33399526
OBJECTIVES: A systematic review and meta-analysis was conducted to determine the cumulative incidences of decannulation and mechanical ventilation weaning in patients with coronavirus disease 2019 (COVID-19) who have undergone a tracheotomy. Weighted average mean times to tracheotomy, to decannulation, and to death were calculated from reported or approximated means. DATA SOURCES: PubMed, SCOPUS, CINAHL, and the Cochrane library. REVIEW METHODS: Studies were screened by 3 investigators independently. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Studies including patients with COVID-19 who underwent a tracheotomy were identified. Studies without reported mechanical ventilation weaning or decannulation were excluded. Data were pooled using a random-effects model. RESULTS: After identifying 232 unique studies, 18 articles encompassing outcomes for 3234 patients were ultimately included for meta-analysis, with a weighted mean follow-up time of 28.6 ± 6.2 days after tracheotomy. Meta-analysis revealed that 55.0% of tracheotomized patients were weaned successfully from mechanical ventilation (95% CI, 47.4%-62.2%). Approximately 34.9% of patients were decannulated successfully, with a mean decannulation time of 18.6 ± 5.7 days after tracheotomy. The pooled mortality in tracheotomized patients with COVID-19 was 13.1%, with a mean time of death of 13.0 ± 4.0 days following tracheotomy. CONCLUSION: At the current state of the coronavirus pandemic, over half of patients who have required tracheotomies are being weaned off of mechanical ventilation. While 13.1% patients have died prior to decannulation, over a third of all tracheotomized patients with COVID-19 reported in the literature have undergone successful decannulation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Respiración Artificial / Traqueotomía / Desconexión del Ventilador / COVID-19 Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Respiración Artificial / Traqueotomía / Desconexión del Ventilador / COVID-19 Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido