{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:22:40Z","timestamp":1774354960551,"version":"3.50.1"},"reference-count":24,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2020,11,16]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twelve tracheostomies were performed for COVID-related respiratory failure. Median patient age was 54 years (range: 36\u201376) and 9 (75%) were male. Median time to tracheostomy was 17 days (range: 10\u201327), and 5 (42%) patients had failed attempts at extubation prior to tracheostomy. There were no intraprocedural complications, including hypoxia. Post-tracheostomy bleeding was noted in two patients. Eight (67%) patients have been discharged at the time of this study, and there were four patient deaths unrelated to tracheostomy placement. No healthcare worker transmissions resulted from participating in the tracheostomy procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A modified percutaneous tracheostomy is feasible and can be safely performed in patients infected with COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>Level V, case series.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2020-000625","type":"journal-article","created":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T07:03:42Z","timestamp":1679814222000},"page":"e000625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Modified percutaneous tracheostomy in patients with COVID-19"],"prefix":"10.1136","volume":"5","author":[{"given":"Beatrice J","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah M","family":"Bechtold","sequence":"additional","affiliation":[{"name":"Anesthesiology, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwayne","family":"Free","sequence":"additional","affiliation":[{"name":"Bronchoscopy and Respiratory Care Services, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Anesthesiology, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick R","family":"Minot","sequence":"additional","affiliation":[{"name":"Anesthesiology, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G","family":"Maggio","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"Spain","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas G","family":"Weiser","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D","family":"Forrester","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"2025082410341603000_5.1.e000625.1","unstructured":"Coronavirus Resource Center . COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University [Internet]. https:\/\/coronavirus.jhu.edu\/map.html (18 Jul 2020)."},{"key":"2025082410341603000_5.1.e000625.2","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/0194599820929640","article-title":"Factors associated with intubation and prolonged intubation in hospitalized patients with COVID-19","volume":"163","author":"Hur","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2025082410341603000_5.1.e000625.3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1213\/ANE.0000000000004830","article-title":"Initial clinical impressions of the critical care of COVID-19 patients in Seattle, New York City, and Chicago","volume":"131","author":"Sommer","year":"2020","journal-title":"Anesth Analg"},{"key":"2025082410341603000_5.1.e000625.4","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00134-020-05935-5","article-title":"Tracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI study","volume":"46","author":"Robba","year":"2020","journal-title":"Intensive Care Med"},{"key":"2025082410341603000_5.1.e000625.5","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182a8fd6a"},{"key":"2025082410341603000_5.1.e000625.6","doi-asserted-by":"publisher","DOI":"10.1177\/1747493015616638"},{"key":"2025082410341603000_5.1.e000625.7","article-title":"Tracheostomy in trauma patients with rib fractures","author":"Fokin","year":"2019","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025082410341603000_5.1.e000625.8","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812440262"},{"key":"2025082410341603000_5.1.e000625.9","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181b5a960"},{"key":"2025082410341603000_5.1.e000625.10","article-title":"Early versus late tracheostomy for critically ill patients","volume":"1","author":"Andriolo","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082410341603000_5.1.e000625.11","doi-asserted-by":"crossref","first-page":"e325","DOI":"10.1097\/CCM.0000000000004239","article-title":"Early tracheostomy in severe traumatic brain injury patients: a meta-analysis and comparison with late tracheostomy","volume":"48","author":"de Franca","year":"2020","journal-title":"Crit Care Med"},{"key":"2025082410341603000_5.1.e000625.12","article-title":"Early percutaneous tracheostomy for patients with COVID\u201019","volume":"55","author":"Williamson","year":"2020","journal-title":"Anaesthesia"},{"key":"2025082410341603000_5.1.e000625.13","unstructured":"Parker NP , Schiff BA , Fritz MA , Rapoport SK . Tracheotomy Recommendations During the COVID-19 Pandemic [Internet]. American Academy of Otolaryngology - Head and Neck Surgery. https:\/\/www.entnet.org\/content\/tracheotomy-recommendations-during-covid-19-pandemic (18 Jul 2020)."},{"key":"2025082410341603000_5.1.e000625.14","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000482"},{"key":"2025082410341603000_5.1.e000625.15","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1016\/j.chest.2020.05.571","article-title":"Use of tracheostomy during the COVID-19 pandemic","volume":"158","author":"Lamb","year":"2020","journal-title":"Chest"},{"key":"2025082410341603000_5.1.e000625.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2004973"},{"key":"2025082410341603000_5.1.e000625.17","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1177\/0194599820931801","article-title":"Safety and prognosis in percutaneous vs surgical tracheostomy in 27 patients with COVID-19","volume":"163","author":"Riestra-Ayora","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2025082410341603000_5.1.e000625.18","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1002\/hed.26261","article-title":"Safe and effective management of tracheostomy in COVID-19 patients","volume":"42","author":"Zhang","year":"2020","journal-title":"Head Neck"},{"key":"2025082410341603000_5.1.e000625.19","doi-asserted-by":"crossref","first-page":"S0003497520306032","DOI":"10.1016\/j.athoracsur.2020.04.010","article-title":"Novel percutaneous tracheostomy for critically ill patients with COVID-19","volume":"110","author":"Angel","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2025082410341603000_5.1.e000625.20","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004166"},{"key":"2025082410341603000_5.1.e000625.21","doi-asserted-by":"crossref","DOI":"10.1016\/j.amjoto.2020.102578","article-title":"Tracheostomy in the intensive care unit: guidelines during COVID-19 worldwide pandemic","volume":"41","author":"Smith","year":"2020","journal-title":"Am J Otolaryngol"},{"key":"2025082410341603000_5.1.e000625.22","article-title":"Tracheostomy in the COVID-19 era: the apneic approach","author":"Papathanakos","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2025082410341603000_5.1.e000625.23","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S2213-2600(20)30230-7","article-title":"Tracheostomy in the COVID-19 era: global and multidisciplinary guidance","volume":"8","author":"McGrath","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2025082410341603000_5.1.e000625.24","doi-asserted-by":"crossref","unstructured":"Volo T , Stritoni P , Battel I , Zennaro B , Lazzari F , Bellin M , Michieletto L , Spinato G , Busatto C , Politi D , et al . 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