Results
The database search yielded 71 citations published between January 1,
2020 and May 24, 2020 (with duplicates removed). 4 articles were
excluded based on our exclusion criteria, 1 of which was due to not
having an available full text in English. The full text of potentially
relevant articles was retrieved for further evaluation. The final number
of papers taken into account was 67. After analysing the selected
articles, a systematic review of literature was done.
17 articles were society guidelines, recommendations, expert
consensuses, surgical considerations or experience regarding tracheotomy
in COVID-19 positive patients. 18 papers discussed the surgical
considerations of tracheotomy during the COVID-19 pandemic.
11 papers were case series or case reports while 7 papers were comment
articles. 3 papers presented frameworks for tracheotomy in COVID-19. 8
papers discussed novel approaches to tracheotomy. 3 papers were
literature reviews of airway management procedures in patients with
COVID-19.
The contents covered by the included articles were then divided into 4
key categories for analyses (with the findings summarised in Tables
1-5): 1) PPE in COVID-19 positive patients, 2) Adjunctive measures of
airway management before definitive intervention in COVID-19 positive
patients; 3) Timing of tracheotomy in COVID-19 positive patients; and 4)
Perioperative considerations in performing tracheotomy in SARS-COV-2
positive patients. Where necessary, the grade of recommendation was
reviewed by the level of evidence.