Tracheostomy in the COVID-19 era: global and multidisciplinary guidance
Tracheostomy in the COVID-19 era: global and multidisciplinary guidance
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DOI：
10.1016/s2213-2600(20)30230-7
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发表时间：
2020-07-01
影响因子：
76.2
通讯作者：
Feller-Kopman, David J.
中科院分区：
文献类型：
--
作者：
McGrath, Brendan A.;Brenner, Michael J.;Feller-Kopman, David J.
由于2019冠状病毒病（COVID-19）大流行，全球卫生保健领域需要机械通气的重症患者数量正出现前所未有的激增。存活者需要相对较长时间的通气，这意味着许多人被认为需要气管切开术，以使患者免于通气支持，并最大限度地利用稀缺资源。COVID-19为气管切开术护理带来了独特的挑战：卫生保健工作者需要安全地进行气管切开术手术并在手术后对患者进行管理，最大限度地减少院内传播风险和降低护理质量。关于病例选择、气管切开术的时机和表现以及患者的后续处理，存在着相互矛盾的建议。为此，我们召集了一个由具有气管切开术相关专业知识的个人组成的国际工作组。我们对COVID-19大流行期间与气管切开术有关的研究报告进行了文献和互联网搜索，并辅以气管切开术护理的声明和指南。通过综合应对患者数量激增的国家的早期经验、新出现的病毒学数据和国际多学科专家意见，我们旨在就COVID-19大流行期间气管切开术的实施和管理提供共识性指南和建议。
Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered fxor tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.