Evidence map›Paper›PMID 34192162›Full record

ArticleTrauma surgery & acute care open2021

Early ventilator liberation and decreased sedation needs after tracheostomy in patients with COVID-19 infection.

Heather Carmichael, Franklin L Wright, Robert C McIntyre, Thomas Vogler, Shane Urban, Sarah E Jolley, Ellen L Burnham, Whitney Firth, Catherine G Velopulos, Juan Pablo Idrovo

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Heather CarmichaelDepartment of Surgery, University of Colorado, Aurora, Colorado, USA.
Franklin L WrightDepartment of Surgery, Division of Gastrointestinal, Trauma and Endocrine Surgery (GITES), University of Colorado, Aurora, Colorado, USA.
Robert C McIntyreDepartment of Surgery, Division of Gastrointestinal, Trauma and Endocrine Surgery (GITES), University of Colorado, Aurora, Colorado, USA.
Thomas VoglerDepartment of Surgery, University of Colorado, Aurora, Colorado, USA.
Shane UrbanTrauma Program, University of Colorado Health, Aurora, Colorado, USA.
Sarah E JolleyDivision of Pulmonary and Critical Care Medicine, University of Colorado, Aurora, Colorado, USA.
Ellen L BurnhamDivision of Pulmonary and Critical Care Medicine, University of Colorado, Aurora, Colorado, USA.
Whitney FirthSurgical/Trauma ICU, University of Colorado Health, Aurora, Colorado, USA.
Catherine G VelopulosDepartment of Surgery, Division of Gastrointestinal, Trauma and Endocrine Surgery (GITES), University of Colorado, Aurora, Colorado, USA.
Juan Pablo IdrovoDepartment of Surgery, Division of Gastrointestinal, Trauma and Endocrine Surgery (GITES), University of Colorado, Aurora, Colorado, USA.
University of Colorado Denver · USUniversity of Colorado Anschutz Medical Campus · USUniversity of Colorado Health · USUniversity of Colorado Hospital · US

Funding

Supplement: CoPARC: Colorado Pulmonary Alcohol Research CollaborativeR24AA019661 · NIAAA · UNIVERSITY OF COLORADO DENVER · PI ELLEN L BURNHAM · 2011 to 2026
$8.5M
Prevalence of ICU-Acquired Myopathy in Patients with Alcohol Use DisordersK23AA026315 · NIAAA · UNIVERSITY OF COLORADO DENVER · PI JOLLEY, SARAH E · 2018 to 2022
$696k
NIAAA NIH HHS K23 AA026315NIAAA NIH HHS R24 AA019661
6 · The paper itself

Abstract

backgroundSince the outset of the coronavirus disease 2019 (COVID-19) pandemic, published tracheostomy guidelines have generally recommended deferral of the procedure beyond the initial weeks of intubation given high mortality as well as concerns about transmission of the infection to providers. It is unclear whether tracheostomy in patients with COVID-19 infection facilitates ventilator weaning, and long-term outcomes are not yet reported in the literature.

methodsThis is a retrospective study of tracheostomy outcomes in patients with COVID-19 infection at a single-center academic tertiary referral intensive care unit. Patients underwent percutaneous tracheostomy at the bedside; the procedure was performed with limited staffing to reduce risk of disease transmission.

resultsBetween March 1 and June 30, 2020, a total of 206 patients with COVID-19 infection required mechanical ventilation and 26 underwent tracheostomy at a mean of 25±5 days after initial intubation. Overall, 81% of tracheostomy patients were liberated from the ventilator at a mean of 9±6 days postprocedure, and 54% were decannulated prior to hospital discharge at a mean of 21±10 days postprocedure. Sedation and pain medication requirements decreased significantly in the week after the procedure. In-hospital mortality was 15%. Among tracheostomy survivors, 68% were discharged to a facility. DISCUSSION: The management of patients with COVID-19 related respiratory failure can be challenging due to prolonged ventilator dependency. In our initial experience, outcomes post-tracheostomy in this population are encouraging, with short time to liberation from the ventilator, a high rate of decannulation prior to hospital discharge, and similar mortality to tracheostomy performed for other indications. Barriers to weaning ventilation in this cohort may be high sedation needs and ventilator dyssynchrony. LEVEL OF EVIDENCE: Level V-Therapeutic/care management.

Indexed as

adultcritical carepneumoniarespiratory distress syndrometracheostomy

Identifiers

PMID34192162
PMCPMC7817387
OpenAlexW3123188914

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.