Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
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Tracheostomy Performed by a Head and Neck Surgeon Under the Supervision of an Intensive Care Unit Specialists in the COVID-19 Era: A Retrospective Analysis

COVID-19 시대에 중환자실 전담의사 감독 하에 두경부 전문의에 의해 시행된 기관절개술에 대한 후향적 분석 연구

  • Han, Won Ho (Department of Surgery, National Cancer Center) ;
  • Lee, Yun Im (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Baek, Sunhwa (Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center) ;
  • Seok, Jungirl (Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center)
  • 한원호 (국립암센터 외과) ;
  • 이윤임 (국립암센터 이비인후과-두경부외과) ;
  • 백선화 (단국대학교 의과대학 내과학교실) ;
  • 석준걸 (단국대학교 의과대학 내과학교실)
  • Received : 2022.03.15
  • Accepted : 2022.05.20
  • Published : 2022.08.31
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Abstract

Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist. Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.

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References

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