Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review.
Identifieur interne : 000445 ( Main/Exploration ); précédent : 000444; suivant : 000446Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review.
Auteurs : Kara D. Meister [États-Unis] ; Vinciya Pandian [États-Unis] ; Alexander T. Hillel [États-Unis] ; Brian K. Walsh [États-Unis] ; Martin B. Brodsky [États-Unis] ; Karthik Balakrishnan [États-Unis] ; Simon R. Best [États-Unis] ; Steven B. Chinn [États-Unis] ; John D. Cramer [États-Unis] ; Evan M. Graboyes [États-Unis] ; Brendan A. Mcgrath [Royaume-Uni] ; Christopher H. Rassekh [États-Unis] ; Joshua R. Bedwell [États-Unis] ; Michael J. Brenner [États-Unis]Source :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [ 1097-6817 ] ; 2020.
Abstract
OBJECTIVE
In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy.
DATA SOURCES
PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents.
REVIEW METHODS
Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations.
CONCLUSIONS
Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel.
IMPLICATIONS FOR PRACTICE
Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.
DOI: 10.1177/0194599820961990
PubMed: 32960148
Affiliations:
- Royaume-Uni, États-Unis
- Angleterre, Californie, Caroline du Nord, Caroline du Sud, Grand Manchester, Maryland, Michigan, Pennsylvanie, Texas, Virginie
- Columbia (Caroline du Sud), Manchester
- Université de Caroline du Sud, Université de Manchester
Links toward previous steps (curation, corpus...)
Le document en format XML
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Cramer</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Graboyes, Evan M" sort="Graboyes, Evan M" uniqKey="Graboyes E" first="Evan M" last="Graboyes">Evan M. 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Mcgrath</name><affiliation wicri:level="4"><nlm:affiliation>University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author><author><name sortKey="Rassekh, Christopher H" sort="Rassekh, Christopher H" uniqKey="Rassekh C" first="Christopher H" last="Rassekh">Christopher H. Rassekh</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Bedwell, Joshua R" sort="Bedwell, Joshua R" uniqKey="Bedwell J" first="Joshua R" last="Bedwell">Joshua R. Bedwell</name><affiliation wicri:level="2"><nlm:affiliation>Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Baylor College of Medicine, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Houston, Texas, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Brenner, Michael J" sort="Brenner, Michael J" uniqKey="Brenner M" first="Michael J" last="Brenner">Michael J. Brenner</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA; Global Tracheostomy Collaborative, Raleigh, North Carolina, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA; Global Tracheostomy Collaborative, Raleigh, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32960148</idno><idno type="pmid">32960148</idno><idno type="doi">10.1177/0194599820961990</idno><idno type="wicri:Area/Main/Corpus">000298</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000298</idno><idno type="wicri:Area/Main/Curation">000298</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000298</idno><idno type="wicri:Area/Main/Exploration">000298</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review.</title><author><name sortKey="Meister, Kara D" sort="Meister, Kara D" uniqKey="Meister K" first="Kara D" last="Meister">Kara D. Meister</name><affiliation wicri:level="2"><nlm:affiliation>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Pandian, Vinciya" sort="Pandian, Vinciya" uniqKey="Pandian V" first="Vinciya" last="Pandian">Vinciya Pandian</name><affiliation wicri:level="2"><nlm:affiliation>Department of Nursing Faculty, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Nursing Faculty, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Hillel, Alexander T" sort="Hillel, Alexander T" uniqKey="Hillel A" first="Alexander T" last="Hillel">Alexander T. Hillel</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Walsh, Brian K" sort="Walsh, Brian K" uniqKey="Walsh B" first="Brian K" last="Walsh">Brian K. Walsh</name><affiliation wicri:level="2"><nlm:affiliation>Department of Health Sciences, Liberty University, Lynchburg, Virginia, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Sciences, Liberty University, Lynchburg, Virginia</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Brodsky, Martin B" sort="Brodsky, Martin B" uniqKey="Brodsky M" first="Martin B" last="Brodsky">Martin B. Brodsky</name><affiliation wicri:level="2"><nlm:affiliation>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Balakrishnan, Karthik" sort="Balakrishnan, Karthik" uniqKey="Balakrishnan K" first="Karthik" last="Balakrishnan">Karthik Balakrishnan</name><affiliation wicri:level="2"><nlm:affiliation>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Best, Simon R" sort="Best, Simon R" uniqKey="Best S" first="Simon R" last="Best">Simon R. Best</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Chinn, Steven B" sort="Chinn, Steven B" uniqKey="Chinn S" first="Steven B" last="Chinn">Steven B. Chinn</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Michigan, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Cramer, John D" sort="Cramer, John D" uniqKey="Cramer J" first="John D" last="Cramer">John D. Cramer</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Graboyes, Evan M" sort="Graboyes, Evan M" uniqKey="Graboyes E" first="Evan M" last="Graboyes">Evan M. Graboyes</name><affiliation wicri:level="4"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea><placeName><region type="state">Caroline du Sud</region><settlement type="city">Columbia (Caroline du Sud)</settlement></placeName><orgName type="university">Université de Caroline du Sud</orgName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Hollings Cancer Center, Charleston, South Carolina, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hollings Cancer Center, Charleston, South Carolina</wicri:regionArea><placeName><region type="state">Caroline du Sud</region></placeName></affiliation></author><author><name sortKey="Mcgrath, Brendan A" sort="Mcgrath, Brendan A" uniqKey="Mcgrath B" first="Brendan A" last="Mcgrath">Brendan A. Mcgrath</name><affiliation wicri:level="4"><nlm:affiliation>University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author><author><name sortKey="Rassekh, Christopher H" sort="Rassekh, Christopher H" uniqKey="Rassekh C" first="Christopher H" last="Rassekh">Christopher H. Rassekh</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Bedwell, Joshua R" sort="Bedwell, Joshua R" uniqKey="Bedwell J" first="Joshua R" last="Bedwell">Joshua R. Bedwell</name><affiliation wicri:level="2"><nlm:affiliation>Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Baylor College of Medicine, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Houston, Texas, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Brenner, Michael J" sort="Brenner, Michael J" uniqKey="Brenner M" first="Michael J" last="Brenner">Michael J. Brenner</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA; Global Tracheostomy Collaborative, Raleigh, North Carolina, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA; Global Tracheostomy Collaborative, Raleigh, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author></analytic><series><title level="j">Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</title><idno type="eISSN">1097-6817</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy.</p></div><div type="abstract" xml:lang="en"><p><b>DATA SOURCES</b></p><p>PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents.</p></div><div type="abstract" xml:lang="en"><p><b>REVIEW METHODS</b></p><p>Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel.</p></div><div type="abstract" xml:lang="en"><p><b>IMPLICATIONS FOR PRACTICE</b></p><p>Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32960148</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1097-6817</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Sep</Month><Day>22</Day></PubDate></JournalIssue><Title>Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</Title><ISOAbbreviation>Otolaryngol Head Neck Surg</ISOAbbreviation></Journal><ArticleTitle>Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review.</ArticleTitle><Pagination><MedlinePgn>194599820961990</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1177/0194599820961990</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy.</AbstractText><AbstractText Label="DATA SOURCES" NlmCategory="METHODS">PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents.</AbstractText><AbstractText Label="REVIEW METHODS" NlmCategory="METHODS">Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel.</AbstractText><AbstractText Label="IMPLICATIONS FOR PRACTICE" NlmCategory="CONCLUSIONS">Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Meister</LastName><ForeName>Kara D</ForeName><Initials>KD</Initials><AffiliationInfo><Affiliation>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pandian</LastName><ForeName>Vinciya</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Nursing Faculty, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hillel</LastName><ForeName>Alexander T</ForeName><Initials>AT</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walsh</LastName><ForeName>Brian K</ForeName><Initials>BK</Initials><AffiliationInfo><Affiliation>Department of Health Sciences, Liberty University, Lynchburg, Virginia, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brodsky</LastName><ForeName>Martin B</ForeName><Initials>MB</Initials><AffiliationInfo><Affiliation>Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Balakrishnan</LastName><ForeName>Karthik</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Pediatric Voice and Swallowing Disorders, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital, Stanford Children's Health, Palo Alto, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Best</LastName><ForeName>Simon R</ForeName><Initials>SR</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chinn</LastName><ForeName>Steven B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Michigan, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cramer</LastName><ForeName>John D</ForeName><Initials>JD</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Graboyes</LastName><ForeName>Evan M</ForeName><Initials>EM</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Hollings Cancer Center, Charleston, South Carolina, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McGrath</LastName><ForeName>Brendan A</ForeName><Initials>BA</Initials><AffiliationInfo><Affiliation>University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rassekh</LastName><ForeName>Christopher H</ForeName><Initials>CH</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bedwell</LastName><ForeName>Joshua R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Baylor College of Medicine, Houston, Texas, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Houston, Texas, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brenner</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA; Global Tracheostomy Collaborative, Raleigh, North Carolina, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Otolaryngol Head Neck Surg</MedlineTA><NlmUniqueID>8508176</NlmUniqueID><ISSNLinking>0194-5998</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">DVT</Keyword><Keyword MajorTopicYN="N">FFP3</Keyword><Keyword MajorTopicYN="N">N95</Keyword><Keyword MajorTopicYN="N">PE</Keyword><Keyword MajorTopicYN="N">SARS</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">VTE</Keyword><Keyword MajorTopicYN="N">aerosol generating procedure</Keyword><Keyword MajorTopicYN="N">deep venous thrombosis</Keyword><Keyword MajorTopicYN="N">health care worker safety</Keyword><Keyword MajorTopicYN="N">laryngectomy</Keyword><Keyword MajorTopicYN="N">laryngotracheal injury</Keyword><Keyword MajorTopicYN="N">pandemic</Keyword><Keyword MajorTopicYN="N">patient safety and quality improvement</Keyword><Keyword MajorTopicYN="N">pulmonary embolism</Keyword><Keyword MajorTopicYN="N">respiratory</Keyword><Keyword MajorTopicYN="N">subglottic stenosis</Keyword><Keyword MajorTopicYN="N">suction</Keyword><Keyword MajorTopicYN="N">tracheal stenosis; tracheocutaneous fistula</Keyword><Keyword MajorTopicYN="N">tracheostomy</Keyword><Keyword MajorTopicYN="N">tracheotomy</Keyword><Keyword MajorTopicYN="N">venous thromboembolism</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>22</Day><Hour>12</Hour><Minute>11</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32960148</ArticleId><ArticleId IdType="doi">10.1177/0194599820961990</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Californie</li><li>Caroline du Nord</li><li>Caroline du Sud</li><li>Grand Manchester</li><li>Maryland</li><li>Michigan</li><li>Pennsylvanie</li><li>Texas</li><li>Virginie</li></region><settlement><li>Columbia (Caroline du Sud)</li><li>Manchester</li></settlement><orgName><li>Université de Caroline du Sud</li><li>Université de Manchester</li></orgName></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Meister, Kara D" sort="Meister, Kara D" uniqKey="Meister K" first="Kara D" last="Meister">Kara D. Meister</name></region><name sortKey="Balakrishnan, Karthik" sort="Balakrishnan, Karthik" uniqKey="Balakrishnan K" first="Karthik" last="Balakrishnan">Karthik Balakrishnan</name><name sortKey="Balakrishnan, Karthik" sort="Balakrishnan, Karthik" uniqKey="Balakrishnan K" first="Karthik" last="Balakrishnan">Karthik Balakrishnan</name><name sortKey="Bedwell, Joshua R" sort="Bedwell, Joshua R" uniqKey="Bedwell J" first="Joshua R" last="Bedwell">Joshua R. Bedwell</name><name sortKey="Bedwell, Joshua R" sort="Bedwell, Joshua R" uniqKey="Bedwell J" first="Joshua R" last="Bedwell">Joshua R. Bedwell</name><name sortKey="Best, Simon R" sort="Best, Simon R" uniqKey="Best S" first="Simon R" last="Best">Simon R. Best</name><name sortKey="Brenner, Michael J" sort="Brenner, Michael J" uniqKey="Brenner M" first="Michael J" last="Brenner">Michael J. Brenner</name><name sortKey="Brodsky, Martin B" sort="Brodsky, Martin B" uniqKey="Brodsky M" first="Martin B" last="Brodsky">Martin B. Brodsky</name><name sortKey="Brodsky, Martin B" sort="Brodsky, Martin B" uniqKey="Brodsky M" first="Martin B" last="Brodsky">Martin B. Brodsky</name><name sortKey="Brodsky, Martin B" sort="Brodsky, Martin B" uniqKey="Brodsky M" first="Martin B" last="Brodsky">Martin B. Brodsky</name><name sortKey="Chinn, Steven B" sort="Chinn, Steven B" uniqKey="Chinn S" first="Steven B" last="Chinn">Steven B. Chinn</name><name sortKey="Cramer, John D" sort="Cramer, John D" uniqKey="Cramer J" first="John D" last="Cramer">John D. Cramer</name><name sortKey="Graboyes, Evan M" sort="Graboyes, Evan M" uniqKey="Graboyes E" first="Evan M" last="Graboyes">Evan M. Graboyes</name><name sortKey="Graboyes, Evan M" sort="Graboyes, Evan M" uniqKey="Graboyes E" first="Evan M" last="Graboyes">Evan M. Graboyes</name><name sortKey="Hillel, Alexander T" sort="Hillel, Alexander T" uniqKey="Hillel A" first="Alexander T" last="Hillel">Alexander T. Hillel</name><name sortKey="Meister, Kara D" sort="Meister, Kara D" uniqKey="Meister K" first="Kara D" last="Meister">Kara D. Meister</name><name sortKey="Pandian, Vinciya" sort="Pandian, Vinciya" uniqKey="Pandian V" first="Vinciya" last="Pandian">Vinciya Pandian</name><name sortKey="Pandian, Vinciya" sort="Pandian, Vinciya" uniqKey="Pandian V" first="Vinciya" last="Pandian">Vinciya Pandian</name><name sortKey="Rassekh, Christopher H" sort="Rassekh, Christopher H" uniqKey="Rassekh C" first="Christopher H" last="Rassekh">Christopher H. Rassekh</name><name sortKey="Walsh, Brian K" sort="Walsh, Brian K" uniqKey="Walsh B" first="Brian K" last="Walsh">Brian K. Walsh</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mcgrath, Brendan A" sort="Mcgrath, Brendan A" uniqKey="Mcgrath B" first="Brendan A" last="Mcgrath">Brendan A. Mcgrath</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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