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Timing of elective tracheotomy and duration of mechanical ventilation amongst patients admitted to intensive care with severe COVID-19: a multicentre prospective cohort study

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Sánchez Barrueco, Álvaro & Albert Prats-Uribe & Marc Tobed & José Miguel Villacampa & Adriana Agüero & Clara García-Bastida & José Ignacio Tato & Laura Rodrigáñez & Victoria Duque Holguera & Estefanía Hernández-García & Daniel Poletti & Gabriela Simonetti & Vanessa Villarraga & Carla Meler-Claramonte & Carlos Chiesa-Estomba & Maria Casasayas & Pablo Parente-Arias & Pedro Castro & Daniel Prieto-Alhambra & Isabel Vilaseca (2021-01 ) .Timing of elective tracheotomy and duration of mechanical ventilation amongst patients admitted to intensive care with severe COVID-19: a multicentre prospective cohort study.

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Sánchez Barrueco, Álvaro & Albert Prats-Uribe & Marc Tobed & José Miguel Villacampa & Adriana Agüero & Clara García-Bastida & José Ignacio Tato & Laura Rodrigáñez & Victoria Duque Holguera & Estefanía Hernández-García & Daniel Poletti & Gabriela Simonetti & Vanessa Villarraga & Carla Meler-Claramonte & Carlos Chiesa-Estomba & Maria Casasayas & Pablo Parente-Arias & Pedro Castro & Daniel Prieto-Alhambra & Isabel Vilaseca. 2021-01 .Timing of elective tracheotomy and duration of mechanical ventilation amongst patients admitted to intensive care with severe COVID-19: a multicentre prospective cohort study.

https://hdl.handle.net/20.500.12080/39411
dc.contributor.author Sánchez Barrueco, Álvaro
dc.contributor.author Albert Prats-Uribe
dc.contributor.author Marc Tobed
dc.contributor.author José Miguel Villacampa
dc.contributor.author Adriana Agüero
dc.contributor.author Clara García-Bastida
dc.contributor.author José Ignacio Tato
dc.contributor.author Laura Rodrigáñez
dc.contributor.author Victoria Duque Holguera
dc.contributor.author Estefanía Hernández-García
dc.contributor.author Daniel Poletti
dc.contributor.author Gabriela Simonetti
dc.contributor.author Vanessa Villarraga
dc.contributor.author Carla Meler-Claramonte
dc.contributor.author Carlos Chiesa-Estomba
dc.contributor.author Maria Casasayas
dc.contributor.author Pablo Parente-Arias
dc.contributor.author Pedro Castro
dc.contributor.author Daniel Prieto-Alhambra
dc.contributor.author Isabel Vilaseca
dc.date.accessioned 2024-01-29T18:14:47Z
dc.date.available 2024-01-29T18:14:47Z
dc.date.created 2021-01
dc.date.issued 2021-01
dc.identifier.uri https://hdl.handle.net/20.500.12080/39411
dc.description.abstract Background: The COVID-19 pandemic has strained intensive care unit (ICU) resources. Tracheotomy is the most frequent surgery performed on ICU patients and can affect the duration of ICU care. We studied the association between when tracheotomy occurs and weaning from mechanical ventilation, mortality, and intraoperative and postoperative complications. Methods: Multicentre prospective cohort including all COVID-19 patients admitted to ICUs in 36 hospitals in Spain who received invasive mechanical ventilation and tracheotomy between 11 March and 20 July 2020. We used a target emulation trial framework to study the causal effects of early (7 to 10 days post-intubation) versus late (>10 days) tracheotomy on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Cause-specific Cox models were used for the first two outcomes and Poisson regression for the third, all adjusted for potential confounders. Findings: We included 696 patients, of whom 142 (20·4%) received early tracheotomy. Using late tracheotomy as the reference group, multivariable cause-specific analysis showed that early tracheotomy was associated with faster post-tracheotomy weaning (fully adjusted hazard ratio (HR) [95% confidence interval (CI)]: 1·31 [1·02 to 1·81]) without differences in mortality (fully adjusted HR [95% CI]: 0·91 [0·56 to 1·47]) or intraoperative or postoperative complications (adjusted rate ratio [95% CI]: 0·21 [0·03 to 1·57] and 1·49 [0·99 to 2·24], respectively). Interpretation: Early tracheotomy reduced post-tracheotomy weaning time, resulting in fewer mechanical ventilation days and shorter ICU stays, without changing complication or mortality rates. These results support early tracheotomy for COVID-19 patients when clinically indicated. Funding: Supported by the NIHR, FAME, and MRC. Key words: SARS-CoV-2, Intensive care, Respiratory failure, weaning, complications. es_ES
dc.format application/pdf es_ES
dc.language eng es_ES
dc.rights CC-BY es_ES
dc.rights.uri http://creativecommons.org/licenses/by/4.0/deed.es es_ES
dc.title Timing of elective tracheotomy and duration of mechanical ventilation amongst patients admitted to intensive care with severe COVID-19: a multicentre prospective cohort study es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.rights.accessrights info:eu-repo/semantics/openAccess es_ES
dc.identifier.location N/A es_ES


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