scholarly journals Coronavirus Disease 2019: A Wake-Up Call for Neurosurgeons to Learn Percutaneous Tracheostomy

2020 ◽  
Author(s):  
Grandhi Aditya ◽  
Dimble Raju ◽  
Jagriti Shukla ◽  
Nabanita Ghosh ◽  
Prasad Krishnan
Keyword(s):  
High Risk ◽  
Traditional Method ◽  
Percutaneous Tracheostomy ◽  
Surgical Tracheostomy ◽  
Neurosurgical Patients ◽  
Open Surgical Tracheostomy

AbstractTracheostomy is a commonly performed operation in neurosurgical patients. It is an aerosol generating procedure and is considered a high-risk operation in times of the coronavirus disease 2019 pandemic. Though percutaneous tracheostomy has been around for some time, many neurosurgeons still perform open surgical tracheostomy as they have been trained in doing so and are well versed with the procedure. However, this pandemic is a wake-up call for them to learn a new skill that is simple, quick, and has several advantages over the traditional method.

scholarly journals Bedside Percutaneous Tracheostomy versus Open Surgical Tracheostomy in Non-ICU Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Evgeni Brotfain ◽  
Leonid Koyfman ◽  
Amit Frenkel ◽  
Michael Semyonov ◽  
Jochanan G. Peiser ◽  
...  
Keyword(s):  
Intensive Care ◽  
Operating Room ◽  
Intensive Care Units ◽  
Medical Staff ◽  
Percutaneous Tracheostomy ◽  
Icu Patients ◽  
Surgical Tracheostomy ◽  
The World ◽  
The Common ◽  
Open Surgical Tracheostomy

Percutaneous bedside tracheostomy (PBT) is a one of the common and safe procedures in intensive care units through the world. In the present paper we published our clinical experience with a performance of PBTs in the regular ward by intensive care physicians’ team. We found it safe and similar outcome in comparison to open surgical tracheostomy method in operation room by ENT team. The performance of PBT in the regular ward showed potential economic advantages in saving medical staff and operating room resources.

scholarly journals Surgical tracheostomy in a cohort of COVID-19 patients

HNO ◽  
2021 ◽  
Author(s):  
Patrick J. Schuler ◽  
Jens Greve ◽  
Thomas K. Hoffmann ◽  
Janina Hahn ◽  
Felix Boehm ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Prolonged Mechanical Ventilation ◽  
Tertiary Care ◽  
Lung Compliance ◽  
Hypoxemic Respiratory Failure ◽  
Surgical Tracheostomy ◽  
Increased Risk ◽  
Open Surgical Tracheostomy ◽  
Sedative Drugs

Abstract Background One of the main symptoms of severe infection with the new coronavirus‑2 (SARS-CoV-2) is hypoxemic respiratory failure because of viral pneumonia with the need for mechanical ventilation. Prolonged mechanical ventilation may require a tracheostomy, but the increased risk for contamination is a matter of considerable debate. Objective Evaluation of safety and effects of surgical tracheostomy on ventilation parameters and outcome in patients with COVID-19. Study design Retrospective observational study between March 27 and May 18, 2020, in a single-center coronavirus disease-designated ICU at a tertiary care German hospital. Patients Patients with COVID-19 were treated with open surgical tracheostomy due to severe hypoxemic respiratory failure requiring mechanical ventilation. Measurements Clinical and ventilation data were obtained from medical records in a retrospective manner. Results A total of 18 patients with confirmed SARS-CoV‑2 infection and surgical tracheostomy were analyzed. The age range was 42–87 years. All patients received open tracheostomy between 2–16 days after admission. Ventilation after tracheostomy was less invasive (reduction in PEAK and positive end-expiratory pressure [PEEP]) and lung compliance increased over time after tracheostomy. Also, sedative drugs could be reduced, and patients had a reduced need of norepinephrine to maintain hemodynamic stability. Six of 18 patients died. All surgical staff were equipped with N99-masks and facial shields or with powered air-purifying respirators (PAPR). Conclusion Our data suggest that open surgical tracheostomy can be performed without severe complications in patients with COVID-19. Tracheostomy may reduce invasiveness of mechanical ventilation and the need for sedative drugs and norepinehprine. Recommendations for personal protective equipment (PPE) for surgical staff should be followed when PPE is available to avoid contamination of the personnel.

Should pulmonary radiographs be taken routinely following paediatric tracheostomy?

2021 ◽  
pp. 021849232110063
Author(s):  
Nazik Yener ◽  
Muhammed Üdürgücü ◽  
Fatma Alaçam ◽  
Muhammed Şükrü Paksu ◽  
İrem Sarı ◽  
...  
Keyword(s):  
High Risk ◽  
Tracheostomy Tube ◽  
Risk Groups ◽  
Age Group ◽  
Paediatric Radiology ◽  
Surgical Tracheostomy ◽  
Emergency Tracheostomy ◽  
New Findings ◽  
Paediatric Age ◽  
Study Support

Aim As the rates of complications related to tracheostomy procedures have fallen in recent years, the routine taking of pulmonary radiographs following tracheostomy has become a matter of debate. The aim of this study was to compare the incidence of complications developing in 120 children who had pulmonary radiographs taken following surgical tracheostomy and to thereby evaluate the necessity of routine pulmonary radiographs after tracheostomy. Methods The data were retrospectively reviewed of 120 children who had pulmonary radiographs taken following surgical tracheostomy between January 2012 and January 2018. The pulmonary radiographs taken before and immediately after tracheostomy were evaluated independently by two paediatric radiology specialists and the results were recorded. Results The incidence of complications after tracheostomy was determined as 23.3%, and no pneumothorax was determined in any patient. An increase was not seen in the complication incidence in those who had undergone emergency tracheostomy and patients aged < 2 years, which are accepted as high-risk groups. In the evaluation of the pre- and post-tracheostomy radiographs, new findings were determined on the post-tracheostomy radiograph that had not been there previously in eight patients (6.6%). These findings were newly formed infiltration in seven patients (5.8%), and malposition of the tracheostomy tube in one patient (0.8%). No pathology requiring intervention was determined on the radiographs of any patient. Conclusion The results of this study support the view that it is not necessary to take pulmonary radiographs routinely following tracheostomy in the paediatric age group, including those at higher risk.

scholarly journals A comparative review of the literature surrounding complications associated with percutaneous dilatational tracheostomy versus open surgical tracheostomy

2018 ◽  
Vol 8 (1) ◽  
pp. 5-11
Author(s):  
Holly  Newton ◽  
Shadaba Ahmed
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Surgical Procedure ◽  
Percutaneous Dilatational Tracheostomy ◽  
Review Of The Literature ◽  
Surgical Tracheostomy ◽  
Dilatational Tracheostomy ◽  
Comparative Review ◽  
Open Surgical Tracheostomy

In this structured review, I aim to discuss the principle of tracheostomies including what they are and why we perform them. My main objective is to explore the literature surrounding whether or not there is a better option between open surgical and percutaneous dilatational tracheostomy, based on the complications with which they are associated. Simply put, a tracheostomy is a common surgical procedure performed on critically ill patients in order to facilitate their breathing. I will discuss the two main types of tracheostomy: open surgical (OST) and percutaneous dilatational (PDT), along with their accompanying impediments. 

scholarly journals Reducing Preventable Readmissions in a Neurosurgical Patient Population at an Academic Medical Center

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Shayan Moosa ◽  
Lindsay Bowerman ◽  
Ellen Smith ◽  
Mindy Bryant ◽  
Natalie Krovetz ◽  
...  
Keyword(s):  
High Risk ◽  
Patient Population ◽  
Medical Center ◽  
Academic Medical Center ◽  
Readmission Rates ◽  
Academic Medical ◽  
Neurosurgical Patient ◽  
Neurosurgical Patients ◽  
Significant Difference

Abstract INTRODUCTION Hospital readmissions are extremely costly in terms of time and resources and negatively impact patient safety and satisfaction. In this study, we performed a Pareto analysis of 30-day readmissions in a neurosurgical patient population in order to identify patients at high-risk for readmission. Using this information, we implemented a new practice parameter with the goal of reducing preventable readmissions. METHODS Patient characteristics and causes for readmission were prospectively collected for all neurosurgical patients readmitted to an academic medical center within 30 d of discharge between July and October 2018. A program was then initiated where postoperative neurosurgical spine patients were contacted by phone at standardized intervals before their 2-wk follow-up appointment, with the purpose of more quickly addressing surgical concerns and/or coordinating care for general medical issues. Finally, 30-d readmission rates were compared between the initial 4-mo period and January 2019 through April 2019. RESULTS Prior to intervention, the largest group of readmitted patients included those who had undergone recent spinal surgery (16/47, 34%). Among spine readmissions during this time, 47% were readmitted before their two-week follow-up appointment, 67% lived over 50 miles from the medical center, and 40% were Medicare-insured. There was a statistically significant difference in the mean rate of spine readmissions per month in the periods before (7.0%) and after (3.0%) the program onset (P = .029, 57% decline). The total number of surgically and medically related spine readmissions decreased between the pre- and postintervention periods from 10 to 3 (70%) and 3 to 1 (67%), respectively. CONCLUSION Our data suggests that a large number of neurosurgical readmissions may be prevented by the simple process of early follow-up and consistent communication via telephone. Readmission rates may be further reduced by standardizing the coordination of postoperative general medical follow-up and providing thorough wound care teaching for high-risk patients.

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