An environmental study of tracheostomy on eight COVID-19 patients.

IF 2.2
Kai Xu, Xin-Hao Zhang, Xiao-Bo Long, Xiang Lu, Zheng Liu
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引用次数: 6

Abstract

Background: Tracheostomy, as an aerosol-generating procedure, is considered as a high-risk surgery for health care workers (HCWs) during the coronavirus disease (COVID-19) pandemic. Current recommendations are to perform tracheostomy after a period of intubation of > 14 days, with two consecutive negative throat swab tests, to lower the risk of contamination to HCWs. However, specific data for this recommendation are lacking. Therefore, this study aimed to evaluate viral shedding into the environment, including HCWs, associated with bedside tracheostomy in the intensive care unit.

Methods: Samples obtained from the medical environment immediately after tracheostomy, including those from 19 surfaces, two air samples at 10 and 50 cm from the surgical site, and from the personal protective equipment (PPE) of the surgeon and assistant, were tested for the presence of severe acute respiratory syndrome coronavirus 2 in eight cases of bedside tracheostomy. We evaluated the rate of positive tests from the different samples obtained.

Results: Positive samples were identified in only one of the eight cases. These were obtained for the air sample at 10 cm and from the bed handrail and urine bag. There were no positive test results from the PPE samples. The patient with positive samples had undergone early tracheostomy, at 9 days after intubation, due to a comorbidity.

Conclusions: Our preliminary results indicate that delayed tracheostomy, after an extended period of endotracheal intubation, might be a considerably less contagious procedure than early tracheostomy (defined as < 14 days after intubation).

8例新型冠状病毒肺炎患者气管切开术环境研究
背景:在冠状病毒病(COVID-19)大流行期间,气管切开术作为一种产生气溶胶的手术,被认为是卫生保健工作者(HCWs)的高风险手术。目前的建议是在插管期> 14天,连续两次咽拭子测试阴性后进行气管切开术,以降低对卫生保健工作者的污染风险。然而,缺乏这一建议的具体数据。因此,本研究旨在评估重症监护病房床边气管切开术中病毒向环境(包括HCWs)的脱落情况。方法:对8例床边气管切开术患者的19个表面、距离手术部位10 cm和50 cm的2个空气样本以及外科医生和助手的个人防护装备进行检测,检测其是否存在严重急性呼吸综合征冠状病毒2型。我们对获得的不同样本的阳性检测率进行了评估。结果:8例中仅1例检出阳性标本。这些是在床扶手和尿袋10厘米处的空气样本中获得的。个人防护装备样本未出现阳性检测结果。样本阳性的患者由于合并症,在插管后9天进行了早期气管切开术。结论:我们的初步结果表明,经过长时间的气管插管后,延迟气管切开术可能比早期气管切开术(定义为
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