Search: onr:"swepub:oai:gup.ub.gu.se/319364" >
TTCOV19: timing of ...
TTCOV19: timing of tracheotomy in SARS-CoV-2-infected patients: a multicentre, single-blinded, randomized, controlled trial
-
- Eeg-Olofsson, Måns, 1967 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
- Pauli, Nina (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
- Hafsten, Louise (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
show more...
-
- Jacobsson, Josephine, 1990 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
-
- Lundborg, Christopher, 1965 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
-
- Brink, Magnus, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
-
- Larsson, Helen, 1982 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
- Lindell, Ellen, 1979 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
- Lowhagen, Karin, 1973 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
-
- Gisslén, Magnus, 1962 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
-
- Bergquist, Henrik, 1969 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar,Institute of Clinical Sciences, Department of Otorhinolaryngology
-
show less...
-
(creator_code:org_t)
- 2022-05-18
- 2022
- English.
-
In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 26:1
- Related links:
-
https://gup.ub.gu.se...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Background: Critically ill COVID-19 patients may develop acute respiratory distress syndrome and the need for respiratory support, including mechanical ventilation in the intensive care unit. Previous observational studies have suggested early tracheotomy to be advantageous. The aim of this parallel, multicentre, single-blinded, randomized controlled trial was to evaluate the optimal timing of tracheotomy. Methods: SARS-CoV-2-infected patients within the Region Vastra Gotaland of Sweden who needed intubation and mechanical respiratory support were included and randomly assigned to early tracheotomy (<= 7 days after intubation) or late tracheotomy (>= 10 days after intubation). The primary objective was to compare the total number of mechanical ventilation days between the groups. Results: One hundred fifty patients (mean age 65 years, 79% males) were included. Seventy-two patients were assigned to early tracheotomy, and 78 were assigned to late tracheotomy. One hundred two patients (68%) underwent tracheotomy of whom sixty-one underwent tracheotomy according to the protocol. The overall median number of days in mechanical ventilation was 18 (IQR 9; 28), but no significant difference was found between the two treatment regimens in the intention-to-treat analysis (between-group difference:- 1.5 days (95% CI -5.7 to 2.8); p= 0.5). A significantly reduced number of mechanical ventilation days was found in the early tracheotomy group during the per-protocol analysis (between-group difference: - 8.0 days (95% CI - 13.8 to - 2.27); p= 0.0064). The overall correlation between the timing of tracheotomy and days of mechanical ventilation was significant (Spearman's correlation: 0.39, p < 0.0001). The total death rate during intensive care was 32.7%, but no significant differences were found between the groups regarding survival, complications or adverse events. Conclusions: The potential superiority of early tracheotomy when compared to late tracheotomy in critically ill patients with COVID-19 was not confirmed by the present randomized controlled trial but is a strategy that should be considered in selected cases where the need for MV for more than 14 days cannot be ruled out.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- COVID-19
- Mechanical ventilation
- Intensive care
- Time factors
- Tracheotomy
- receiving mechanical ventilation
- intensive-care-unit
- tracheostomy
- intubation
- mortality
- covid-19
- pneumonia
- impact
- General & Internal Medicine
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Eeg-Olofsson, Må ...
-
Pauli, Nina
-
Hafsten, Louise
-
Jacobsson, Josep ...
-
Lundborg, Christ ...
-
Brink, Magnus, 1 ...
-
show more...
-
Larsson, Helen, ...
-
Lindell, Ellen, ...
-
Lowhagen, Karin, ...
-
Gisslén, Magnus, ...
-
Bergquist, Henri ...
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
- Articles in the publication
-
Critical Care
- By the university
-
University of Gothenburg