An environmental study of tracheostomy on eight COVID-19 patients.
An environmental study of tracheostomy on eight COVID-19 patients.
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对 8 名 COVID-19 患者进行气管切开术的环境研究
DOI：
10.1186/s40463-021-00494-1
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发表时间：
2021-01-18
期刊：
影响因子：
--
通讯作者：
Liu Z
中科院分区：
文献类型：
--
作者：
Xu K;Zhang XH;Long XB;Lu X;Liu Z
背景气管切开术作为一种气溶胶生成手术，在冠状病毒病（COVID-19）大流行期间被认为是医护人员（HCW）的高风险手术。目前的建议是在插管超过14天后进行气管切开术，连续两次咽拭子检测阴性，以降低HCW污染的风险。然而，这一建议缺乏具体数据。因此，本研究的目的是评估病毒脱落到环境中，包括HCW，与床边气管切开术在重症监护室。MethodsSamples气管切开术后立即从医疗环境中获得，包括那些从19个表面，两个空气样品在10和50厘米的手术部位，并从个人防护装备（PPE）的外科医生和助理，在8例床边气管切开术中检测了严重急性呼吸系统综合征冠状病毒2的存在。我们评估了从不同的samples.ResultsPositive样品的阳性检测率被确定在只有一个八例。这些是从10 cm处的空气样品以及从床扶手和尿袋中获得的。PPE样本的检测结果无阳性。阳性样本的患者进行了早期气管切开术，在插管后9天，由于comormorphis.ConclusionsOur初步结果表明，延迟气管切开术，经过一段时间的气管内插管，可能是一个相当少的传染性程序比早期气管切开术（定义为< 14天后插管）。
BackgroundTracheostomy, as an aerosol-generating procedure, is considered as a high-risk surgery for health care workers (HCWs) during the coronavirus disease (COVID-19) pandemic. Current recommendations are to perform tracheostomy after a period of intubation of > 14 days, with two consecutive negative throat swab tests, to lower the risk of contamination to HCWs. However, specific data for this recommendation are lacking. Therefore, this study aimed to evaluate viral shedding into the environment, including HCWs, associated with bedside tracheostomy in the intensive care unit.MethodsSamples obtained from the medical environment immediately after tracheostomy, including those from 19 surfaces, two air samples at 10 and 50 cm from the surgical site, and from the personal protective equipment (PPE) of the surgeon and assistant, were tested for the presence of severe acute respiratory syndrome coronavirus 2 in eight cases of bedside tracheostomy. We evaluated the rate of positive tests from the different samples obtained.ResultsPositive samples were identified in only one of the eight cases. These were obtained for the air sample at 10 cm and from the bed handrail and urine bag. There were no positive test results from the PPE samples. The patient with positive samples had undergone early tracheostomy, at 9 days after intubation, due to a comorbidity.ConclusionsOur preliminary results indicate that delayed tracheostomy, after an extended period of endotracheal intubation, might be a considerably less contagious procedure than early tracheostomy (defined as < 14 days after intubation).
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