Results
Since March 8th, 2020 to April 25th 2020 thirty
Covid-19 patients were managed in the Covid intensive care units(ICU) of
[Blinded for review]. Ten patients died, eleven patients were
discharged and nine patients are being currently managed. Four (13%)
tracheostomies were performed at bedside in our Covid ICUs. Demographic
and clinical variables are reported in table 1.
All four patients needed prolonged mechanical ventilation, because of
the acute respiratory failure, and had developed ventilator associated
pneumonia (VAP) before performing tracheotomy. In three patients,
gram-negative bacteria were isolated from the bronchial aspirates and
one developed lung and paranasal fungal infection from zygomices. All
patients underwent tracheotomy while recovering from septic shock and
were still hemodynamically supported by a low dose of vasopressors.
After tracheotomy, one patient (PA) has been weaned from mechanical
ventilation on day 28th, one (OI) died after 18 days of mechanical
ventilation because of recurrent severe septic shock, associated with
gram-negative infection with a progressive worsening of multi-organ
functions. MG developed a severe invasive fungal infection, with
isolation of a zygomices from the bronchial aspirate and he is
still on mechanical ventilation. The last one (FI) resulted negative for
SARS-nCoV2 on bronchoalveolar lavage after 22 days of mechanical
ventilation, with a significant improvement of oxygenation
(PaO2/FiO2>300) and he has been considered cured from
COVID-19 and moved to a COVID-free ICU to complete the weaning from the
ventilator.
“Surgical” endpoints are reported in table 2.