Pediatric tracheostomy in COVID-19 pandemic: a review

Abstract

Coronavirus disease 2019 (COVID-19) is a highly contagious infection caused by a novel strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity of the COVID-19 infection of the pediatric patient varies broadly between a mild cough and fever to severe form of diseases such as acute respiratory distress syndrome (ARDS) for which some may need intubation and followed by mechanical ventilation through tracheostomy in case of prolonged ventilation. Performing tracheostomy in pediatric patient pose a challenge for health care professional as there is high chance of spread of the disease in COVID-19 pandemic. Surgical tracheostomy is an aerosol generating procedure which causes high chance of spread of infections. There is increasing concern for high transmissibility of the virus to the operating surgeon with their assisting staff and other nearby patients. Pediatric tracheostomy should be performed with close association with pediatric otolaryngologists, anesthesiologists and pediatric intensive care physicians along with adequate personal protective equipment (PPE) for smooth and safe execution of the procedure.