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PREVENTING NOSOCOMIAL TRANSMISSION DURING TRACHEOSTOMY FOR COVID-19 PNEUMONIA IN ICU: LESSONS LEARNED FROM AN ITALIAN “HOT SPOT”
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  • Luca D'Ascanio,
  • Gino Latini,
  • Manlio Pandolfini,
  • Damiano Giardini,
  • Cristina Cingolani,
  • Emanuela Battisti,
  • Emiliano Milazzo,
  • Maria Capalbo,
  • Michele Tempesta
Luca D'Ascanio
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Gino Latini
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Manlio Pandolfini
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Damiano Giardini
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Cristina Cingolani
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Emanuela Battisti
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Emiliano Milazzo
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Maria Capalbo
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Michele Tempesta
Azienda Ospedaliera Ospedali Riuniti Marche Nord
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Abstract

Objective: Surgical/anesthetic management of patients undergoing surgical tracheostomy for Covid-19 pneumonia aiming at minimizing the risk of health care workers (HCWs) infection. Design, Setting and Paticipants: Twenty-three Caucasian patients, mean age 67 years, with long-term orotracheal intubation for severe acute respiratory syndrome Covid-19 pneumonia were submitted to surgical tracheostomy, between February 3rd and March 22nd 2020, according to our specific procedure. Main outcomes and Measures: Air exposure time (AET) and frequency of infection in HCWs. Results: No complication, in terms of bleeding or tracheostomy cannula displacement, was observed. No HCWs involved in the procedures contracted Covid-19. Conclusions: The tracheostomy technique we describe minimizes the risk of surgeon’s exposure to patient’s aerosol drops/expired air and the possibility of HCWs infection during the procedure carried out in patients with Covid-19 pneumonia. The details and advantages of our approach with respect to “standard” tracheotomy and percutaneous procedures are discussed.