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Methods for a Seamless Transition From Tracheostomy to Spontaneous Breathing in Patients With COVID-19 #MMPMID32759372
Divo MJ; Oberg CL; Pritchett MA; Celli BR; Folch EE
Respir Care 2020[Nov]; 65 (11): 1773-1783 PMID32759372show ga
The COVID-19 pandemic has profoundly affected health care delivery worldwide. A small yet significant number of patients with respiratory failure will require prolonged mechanical ventilation while recovering from the viral-induced injury. The majority of reports thus far have focused on the epidemiology, clinical factors, and acute care of these patients, with less attention given to the recovery phase and care of those patients requiring extended time on mechanical ventilation. In this paper, we review the procedures and methods to safely care for patients with COVID-19 who require tracheostomy, gastrostomy, weaning from mechanical ventilation, and final decannulation. The guiding principles consist of modifications in the methods of airway care to safely prevent iatrogenesis and to promote safety in patients severely affected by COVID-19, including mitigation of aerosol generation to minimize risk for health care workers.