Performing tracheostomy on COVID-19 pediatric patients at intensive care unit: Our experiences

Abstract

Background: The novel coronavirus disease-2019 (COVID-19) is posing unprecedented challenges among health-care workers for managing the pediatric tracheostomy. Tracheostomy and posttracheostomy care are considered as high-risk procedures for contamination of health-care workers and other patients of the intensive care unit (ICU) in COVID-19 pandemic. Objective: The objective of this retrospective study is to evaluate the details of pediatric tracheostomy including patients profile, surgical steps, complications, and precautions by health-care workers at the ICU of the specially assigned hospital for COVID-19 patients. Materials and Methods: This is a descriptive retrospective study in which 18 COVID-19 pediatric patients underwent bedside surgical tracheostomy at the ICU. Clinical patient s profiles such as age, sex, comorbidities, complication of the tracheostomy, ventilator withdrawal after tracheostomy, and nosocomial infections of the health-care professionals related to tracheostomy were analyzed. Results: Of the 18 patients with COVID-19 infections who underwent tracheostomy, there were 11 male (61.11%) and 7 female (38.88%) with a male-to-female ratio being 17:1. The age ranged from 4 years to 18 years, with a mean age of 11.45 years. The mean duration from the day of the orotracheal intubation to the day of tracheostomy was 12 days. Conclusion: Performing surgical tracheostomy on COVID-19 pediatric patients is a high-risk aerosol-generating procedure for health-care professionals. It should be performed with close association with pediatric otolaryngologists, anesthesiologists, and pediatric intensive care physicians along with adequate personal protective equipment for smooth and safe execution of the procedure.