Vocalia societe generale series#

The following recommendations have been drawn up by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) and the Spanish Society of Anaesthesiology and Critical Care (SEDAR).

Vocalia societe generale series#

percutaneous tracheotomy), or the subsequent treatment of these patients.Īlthough some authors have published case series describing their experience with tracheotomy in patients with COVID-19, there is still insufficient evidence to support firm recommendations therefore, expert consensus and a review of the literature in the context of routine practice can help establish guidelines for performing tracheotomy in this disease. 9ĭifferent recommendations for tracheotomy techniques in patients with COVID-19 have been published, but there is insufficient evidence on the optimal timing of the procedure, the type of approach (surgical vs. The risk of contagion is high when performing aerosol-generating procedures, among which tracheal intubation, fibreoptic bronchoscopy and tracheostomy are considered to involve the highest risk. Specific recommendations on personal protective equipment (PPE) and airway management involving intubation and mechanical ventilation have been established. SARS-CoV-2 has shown a high rate of infection, especially by airborne and droplet transmission. 8 The appearance of delirium, common in this type of patient, can also affect weaning from mechanical ventilation. The use of specific antiviral drugs can interact with sedatives and analgesics and prolong their effects. 7 This means that many patients will remain on mechanical ventilation for several days, and will be at high risk of developing ICU-acquired weakness, making it difficult to wean them from the ventilator. 6 These patients require ventilation strategies that call for deep analgesic sedation, and even muscle relaxation, protective ventilation, recruitment manoeuvres and prone positioning, in the initial phases. Mortality among patients with COVID-19 on mechanical ventilation can be as high as 50%. 2–4 Surgical tracheotomy is the most common procedure in critically ill patients with COVID-19. Between 9.8% and 15.2% of these patients required mechanical ventilation in different series published. In the recent pandemic, COVID-19 in its most severe form presents with acute respiratory failure that can progress to acute respiratory distress syndrome (ARDS), which in many patients requires mechanical ventilation. In intensive care units (ICU), tracheotomy is a common procedure in patients with respiratory failure who require mechanical ventilation.