THE ROLE OF TRACHEOTOMY IN WEANING FROM MECHANICAL VENTILATION IN PATIENTS WITH COVID-19/COVID-19 HASTALARINDA MEKANIK VENTILASYONDAN AYRILMADA TRAKEOTOMININ ROLU

Objective: Significant numbers of COVID-19 patients require invasive mechanical ventilation support during their treatment. Prolonged mechanical ventilation causes a tracheotomy need in some of those patients. The study aimed to assess the possible benefits of tracheotomy in patients with COVID-19 and its effect on clinical outcomes. Material and Method: Six patients with COVID-19 who underwent an open tracheotomy in our institution were retrospectively reviewed. Its effect on the prognosis, the effectiveness of the safety precautions, and personnel protective equipment (PPE) utilization during the tracheotomy procedures was evaluated. Results: Mean intubation period before a tracheotomy was 21 days (range, 14-28). All patients were male with a mean age of 62. Five of them died postoperatively. One patient was discharged and decannulated. None of the airway team members were infected after the procedures. Conclusion: Tracheotomy in COVID-19 patients is a safe procedure when appropriate PPE measures are taken. Our data do not support the contribution of tracheotomy to accelerating ventilator weaning in patients with COVID-19. Keywords: COVID-19, Tracheotomy, Mechanical ventilation Amac: COVID-19 hastalarinin onemli bir kismina, tedavileri sirasinda invazif mekanik ventilasyon destegi gerekir. Uzun sureli mekanik ventilasyon, bu hastalarin bazilarinda trakeotomi ihtiyacini ortaya cikarir. Calismada, COVID-19 hastalarinda trakeotominin olasi faydalarini ve klinik sonuclar uzerindeki etkisinin degerlendirilmesi amaclandi. Gerec ve Yontem: Kurumumuzda acik trakeotomi yapilan alti adet COVID-19 hastasi retrospektif olarak incelendi. Trakeotomi islemleri sirasinda guvenlik onlemlerinin etkinligi, kisisel koruyucu ekipman (KKE) kullanimi ve islemin prognoza etkisi degerlendirildi. Bulgular: Trakeotomi oncesi ortalama entubasyon suresi 21 gundu (aralik, 14-28). Tum hastalar erkekti ve ortalama yas 62 idi. Hastalarin besi ameliyat sonrasi donemde oldu. Bir hasta taburcu edildi ve dekanule edildi. Islemlerden sonra havayolu ekibinin hicbir uyesi enfekte olmadi. Sonuc: COVID-19 hastalarinda trakeotomi, uygun KKE onlemleri alindiginda guvenli bir islemdir. Verilerimiz, COVID-19'lu hastalarda trakeotominin hastalari mekanik ventilatorden ayirmayi kolaylastirdigini desteklemedi. Anahtar Kelimeler: COVID-19, Trakeotomi, Mekanik ventilasyon