3. Results
Hybrid MPDT was successfully performed in 20 COVID‐19 patients. No medical staff member was infected and the average procedural time was 6.45±1.02 min. In two patients that received continuous heparin infusion during ECMO (Extracorporeal membrane oxygenation), tracheostomy site bleeding occurred in subcutaneous soft tissue or the strap muscle, respectively. No other complication (e.g., pneumothorax or subcutaneous emphysema) was encountered.
Participants included 20 patients, 18 men and 2 women, with an overall mean (SD) age of 65.5 (8.07) years. Acute respiratory distress syndrome (ARDS) was the most common indication for tracheostomy (12 patients, 60%), followed by failure to wean ventilation without ARDS (4 patients, 20%), extracorporeal membrane oxygenation (ECMO) decannulation (3 patients, 15%), and need for sedation management (1 patient, 5%). A total of 20 patients, of which 0 (00.0%), 10 (50.0%), 6 (30.0%), and 4 (20.0%) had a CCIS of 0, 1–2, 3–4, and > 4, respectively. The mean (SD) APACHE II score for patients who received a tracheostomy was 8.4 (3.2). Mean (SD) time endotracheal intubation to tracheostomy was 18 (66) days. The mean (SD) time to discontinuation of mechanical ventilation was 31.4 (17.8) days; and from tracheostomy to decannulation, 49.5(18.50) days. The mean (SD) length of hospital stay for all patients was 65.5 (27.5) days. Mean (SD) follow-up periods after tracheotomy was 64 (35) days. The all-cause in-hospital mortality following tracheostomy in COVID-19 patients was 10% with two deaths.