{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:06:53Z","timestamp":1768550813658,"version":"3.49.0"},"posted":{"date-parts":[[2021,2,25]]},"group-title":"Intensive Care and Critical Care Medicine","reference-count":14,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2021,2,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>SARS-CoV-2 can cause severe respiratory failure leading to prolonged mechanical ventilation. Data are just emerging about the practice and outcomes of tracheostomy in these patients. We reviewed our experience with tracheostomies for SARS-CoV-2 at our tertiary-care, urban teaching hospital.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed the demographics, comorbidities, timing of mechanical ventilation, tracheostomy, and ICU and hospital lengths-of-stay (LOS) in SARS-CoV-2 patients who received tracheostomies. Early tracheostomy was considered &lt;14 days of ventilation. Medians with interquartile ranges (IQR) were calculated and compared with Wilcoxon rank sum, Spearman correlation, Kruskal-Wallis, and regression modeling.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From March 2020 to January 2021, our center had 370 patients intubated for SARS-CoV-2, and 59 (16%) had percutaneous bedside tracheostomy. Median time from intubation to tracheostomy was 19 (IQR 17 \u2013 24) days. Demographics and comorbidities were similar between early and late tracheostomy, but early tracheostomy was associated with shorter ICU LOS and a trend towards shorter ventilation. To date, 34 (58%) of patients have been decannulated, 17 (29%) before hospital discharge; median time to decannulation was 24 (IQR 19-38) days. Decannulated patients were younger (56 vs 69 years), and in regression analysis, pneumothorax was associated was associated with lower decannulation rates (OR 0.05, 95CI 0.01 \u2013 0.37). No providers developed symptoms or tested positive for SARS-CoV-2.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Tracheostomy is a safe and reasonable procedure for patients with prolonged SARS-CoV-2 respiratory failure. We feel that tracheostomy enhances care for SARS-CoV-2 since early tracheostomy appears associated with shorter duration of critical care, and decannulation rates appear high for survivors.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2021.02.23.21252231","type":"posted-content","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T05:57:06Z","timestamp":1614232626000},"source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of Percutaneous Tracheostomy for Patients with SARS-CoV-2 Respiratory Failure"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8687-0063","authenticated-orcid":false,"given":"Jason","family":"Arnold","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-3943","authenticated-orcid":false,"given":"Catherine A.","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3294-6752","authenticated-orcid":false,"given":"Elizabeth","family":"Malsin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-8522","authenticated-orcid":false,"given":"Kristy","family":"Todd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-7690","authenticated-orcid":false,"given":"A. Christine","family":"Argento","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0084-8760","authenticated-orcid":false,"given":"Michael","family":"Cuttica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1246-3814","authenticated-orcid":false,"suffix":"III","given":"John M.","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8527-4195","authenticated-orcid":false,"given":"Richard G.","family":"Wunderink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8796-3966","authenticated-orcid":false,"given":"Sean B.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the NU COVID Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"issue":"3","key":"2021022611100885000_2021.02.23.21252231v1.1","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.athoracsur.2020.04.010","article-title":"Novel Percutaneous Tracheostomy for Critically Ill Patients With COVID-19","volume":"110","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2021022611100885000_2021.02.23.21252231v1.2","doi-asserted-by":"crossref","unstructured":"Aviles-Jurado FX , Prieto-Alhambra D , Gonzalez-Sanchez N , et al. Timing, Complications, and Safety of Tracheotomy in Critically Ill Patients With COVID-19. JAMA Otolaryngol Head Neck Surg. 2020.","DOI":"10.1001\/jamaoto.2020.3641"},{"key":"2021022611100885000_2021.02.23.21252231v1.3","doi-asserted-by":"crossref","unstructured":"Chao TN , Harbison SP , Braslow BM , et al. Outcomes after Tracheostomy in COVID-19 Patients. Ann Surg. 2020.","DOI":"10.1097\/SLA.0000000000004166"},{"issue":"5","key":"2021022611100885000_2021.02.23.21252231v1.4","doi-asserted-by":"crossref","first-page":"366","DOI":"10.5114\/ait.2020.101216","article-title":"Percutaneous tracheostomy for long-term ventilated COVID-19-patients: rationale and first clinical-safe for all-experience","volume":"52","year":"2020","journal-title":"Anaesthesiol Intensive Ther"},{"key":"2021022611100885000_2021.02.23.21252231v1.5","doi-asserted-by":"crossref","unstructured":"Martin-Villares C , Perez Molina-Ramirez C , Bartolome-Benito M , Bernal-Sprekelsen M , Group COEC. 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