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This article outlines the procedural modifications required for patients with COVID-19 focusing on minimizing transmission risk during this aerosol-generating procedure. It is important that deflation of the cuff, replacement of the tracheostomy tube, and decannulation should be performed only after the patient has fulfilled the criteria for viral clearance.
Percutaneous tracheostomy can be performed safely during the COVID-19 pandemic.
– Kolene E. Bailey, MD
This abstract is available on the publisher's site.
A tracheostomy is a surgically created airway that is kept open with a breathing tube, or tracheostomy tube. The tube is inserted directly into the trachea through an incision in the neck. A tracheostomy can be created with an open surgical or a percutaneous dilation technique and can take place in the operating room or at the patient’s bedside. The open technique involves dissection of the anterior pretracheal tissue and insertion of a tracheostomy tube under direct visualization. The percutaneous technique can be performed quickly and safely at the bedside with the use of a modified Seldinger technique and bronchoscopic guidance. This approach is associated with fewer bleeding complications than open tracheostomy and similar long-term morbidity.