{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:16:46Z","timestamp":1790803006314,"version":"4.1.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Tracheostomy has been proposed as an option to help organize the healthcare system to face the unprecedented number of patients hospitalized for a COVID-19-related acute respiratory distress syndrome (ARDS) in intensive care units (ICU). It is, however, considered a particularly high-risk procedure for contamination. This paper aims to provide our experience in performing tracheostomies on COVID-19 critically ill patients during the pandemic and its long-term local complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a retrospective analysis of prospectively collected data of patients tracheostomized for a COVID-19-related ARDS in two university hospitals in the Paris region between January 27<jats:sup>th<\/jats:sup> (date of first COVID-19 admission) and May 18<jats:sup>th<\/jats:sup>, 2020 (date of last tracheostomy performed). We focused on tracheostomy technique (percutaneous <jats:italic>versus<\/jats:italic> surgical), timing (early <jats:italic>versus<\/jats:italic> late) and late complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Forty-eight tracheostomies were performed with an equal division between surgical and percutaneous techniques. There was no difference in patients\u2019 characteristics between surgical and percutaneous groups. Tracheostomy was performed after a median of 17 [12\u201322] days of mechanical ventilation (MV), with 10 patients in the \u201cearly\u201d group (\u2264 day 10) and 38 patients in the \u201clate\u201d group (&gt; day 10). Survivors required MV for a median of 32 [22\u201341] days and were ultimately decannulated with a median of 21 [15\u201334] days spent on cannula. Patients in the early group had shorter ICU and hospital stays (respectively 15 [12\u201319] <jats:italic>versus<\/jats:italic> 35 [25\u201347] days; p = 0.002, and 21 [16\u201328] <jats:italic>versus<\/jats:italic> 54 [35\u201372] days; p = 0.002) and spent less time on MV (respectively 17 [14\u201320] and 35 [27\u201343] days; p&lt;0.001). Interestingly, patients in the percutaneous group had shorter hospital and rehabilitation center stays (respectively 44 [34\u201381] <jats:italic>versus<\/jats:italic> 92 [61\u2013118] days; p = 0.012, and 24 [11\u201338] <jats:italic>versus<\/jats:italic> 45 [22\u201371] days; p = 0.045). Of the 30 (67%) patients examined by a head and neck surgeon, 17 (57%) had complications with unilateral laryngeal palsy (n = 5) being the most prevalent.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Tracheostomy seems to be a safe procedure that could help ICU organization by delegating work to a separate team and favoring patient turnover by allowing faster transfer to step-down units. Following guidelines alone was found sufficient to prevent the risk of aerosolization and contamination of healthcare professionals.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261024","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T18:31:06Z","timestamp":1640197866000},"page":"e0261024","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Tracheostomy in COVID-19 acute respiratory distress syndrome patients and follow-up: A parisian bicentric retrospective cohort"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2462-4902","authenticated-orcid":true,"given":"Diane","family":"Evrard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Jurcisin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maksud","family":"Assadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Patrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Tafani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-4402","authenticated-orcid":true,"given":"Nicolas","family":"Ullmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Timsit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-5705","authenticated-orcid":true,"given":"Philippe","family":"Montravers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrix","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha","family":"Rozencwajg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"pone.0261024.ref001","first-page":"1","article-title":"COVID-19 pneumonia: different respiratory treatments for different phenotypes?","author":"L Gattinoni","year":"2020","journal-title":"Intensive Care Med"},{"issue":"8","key":"pone.0261024.ref002","first-page":"1056","article-title":"Tracheostomy: Why, When, and How?","volume":"55","author":"CG Durbin","year":"2010","journal-title":"Respir Care"},{"key":"pone.0261024.ref003","article-title":"Early percutaneous tracheostomy for patients with COVID\u201019","author":"A Williamson","year":"2020","journal-title":"Anaesthesia"},{"key":"pone.0261024.ref004","article-title":"Rapport SFAR: Preconisations-pour-lutilisation-parcimonieuse-des-molecules-en-tension-durant-la-pandemie-covid-19","author":"J-M Constantin","year":"2020"},{"issue":"4","key":"pone.0261024.ref005","doi-asserted-by":"crossref","first-page":"e35797","DOI":"10.1371\/journal.pone.0035797","article-title":"Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review","volume":"7","author":"K Tran","year":"2012","journal-title":"PloS One"},{"issue":"2","key":"pone.0261024.ref006","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/anae.15292","article-title":"A quantitative evaluation of aerosol generation during tracheal intubation and extubation","volume":"76","author":"J Brown","year":"2021","journal-title":"Anaesthesia"},{"key":"pone.0261024.ref007","article-title":"What Is an Aerosol-Generating Procedure?","author":"M Klompas","year":"2020","journal-title":"JAMA Surg"},{"key":"pone.0261024.ref008","volume-title":"R\u00e9animation","author":"P Sauder","year":"2008"},{"key":"pone.0261024.ref009","article-title":"Prise en charge du Syndrome de D\u00e9tresse Respiratoire Aig\u00fce (SDRA) de l\u2019adulte \u00e0 la phase initiale- Recommandations Formalis\u00e9es d\u2019Experts","author":"L Papazian","year":"2018","journal-title":"SRLF"},{"key":"pone.0261024.ref010","unstructured":"Recommandations d\u2019experts portant sur la prise en charge en r\u00e9animation des patients en p\u00e9riode d\u2019\u00e9pid\u00e9mie \u00e0 SARS-CoV2\u2014La SFAR. Soci\u00e9t\u00e9 Fran\u00e7aise d\u2019Anesth\u00e9sie et de R\u00e9animation. 2020. Available from: https:\/\/sfar.org\/recommandations-dexperts-portant-sur-la-prise-en-charge-en-reanimation-des-patients-en-periode-depidemie-a-sars-cov2\/"},{"key":"pone.0261024.ref011","first-page":"8","article-title":"Tracheotomy in the intensive care unit: guidelines from a French expert panel","author":"JL Trouillet","year":"2018","journal-title":"Ann Intensive Care"},{"issue":"10","key":"pone.0261024.ref012","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1097\/00005537-200310000-00022","article-title":"Safe tracheostomy for patients with severe acute respiratory syndrome","volume":"113","author":"WI Wei","year":"2003","journal-title":"The Laryngoscope"},{"issue":"4","key":"pone.0261024.ref013","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1213\/ANE.0000000000005100","article-title":"Is Surgical Tracheostomy Better Than Percutaneous Tracheostomy in COVID-19\u2013Positive Patients?","volume":"131","author":"M Bassi","year":"2020","journal-title":"Anesth Analg"},{"issue":"5","key":"pone.0261024.ref014","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.bjoms.2020.04.008","article-title":"Surgical tracheostomies in Covid-19 patients: important considerations and the \u201c5Ts\u201d of safety","volume":"58","author":"D Broderick","year":"2020","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"7","key":"pone.0261024.ref015","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":"BA McGrath","year":"2020","journal-title":"Lancet Respir Med"},{"key":"pone.0261024.ref016","article-title":"Early versus late tracheostomy for critically ill patients","author":"BN Andriolo","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"20","key":"pone.0261024.ref017","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1001\/jama.2013.5154","article-title":"TracMan Collaborators for the. Effect of Early vs Late Tracheostomy Placement on Survival in Patients Receiving Mechanical Ventilation: The TracMan Randomized Trial","volume":"309","author":"D Young","year":"2013","journal-title":"JAMA"},{"key":"pone.0261024.ref018","first-page":"1","article-title":"Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study","year":"2020","journal-title":"Intensive Care Med"},{"key":"pone.0261024.ref019","article-title":"Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients.","author":"C Tornari","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0261024.ref020","article-title":"Tracheostomy in patients with COVID-19: predictors and clinical features","author":"J Sancho","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0261024.ref021","first-page":"194599820984780","article-title":"Tracheotomy in COVID-19 Patients: A Systematic Review and Meta-analysis of Weaning, Decannulation, and Survival","author":"DA Benito","year":"2021","journal-title":"Otolaryngol Neck Surg"},{"issue":"3","key":"pone.0261024.ref022","doi-asserted-by":"crossref","first-page":"2473974X20957636","DOI":"10.1177\/2473974X20957636","article-title":"Surgical Tracheostomies in COVID-19 Patients: Indications, Technique, and Results in a Second-Level Spanish Hospital.","volume":"4","author":"A Zuazua-Gonzalez","year":"2020","journal-title":"OTO Open"},{"key":"pone.0261024.ref023","first-page":"1","article-title":"Tracheostomy in the coronavirus disease 2019 patient: evaluating feasibility, challenges and early outcomes of the 14-day guidance","author":"N Glibbery","journal-title":"J Laryngol Otol"},{"issue":"1","key":"pone.0261024.ref024","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/0194599820928963","article-title":"Elective Tracheostomy During Mechanical Ventilation in Patients Affected by COVID-19: Preliminary Case Series From Lombardy, Italy","volume":"163","author":"M Turri-Zanoni","year":"2020","journal-title":"Otolaryngol Neck Surg"},{"key":"pone.0261024.ref025","first-page":"1","article-title":"Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society","author":"C Piazza","year":"2020","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"pone.0261024.ref026","article-title":"Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline","author":"A Rovira","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0261024.ref027","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2020.615845","article-title":"Tracheostomy in 80 COVID-19 Patients: A Multicenter, Retrospective, Observational Study","volume":"7","author":"Y Tang","year":"2020","journal-title":"Front Med"},{"key":"pone.0261024.ref028","first-page":"1","article-title":"Elective tracheostomy during COVID-19 outbreak: to whom, when, how? Early experience from Venice, Italy","author":"T Volo","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0261024.ref029","first-page":"1","article-title":"Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain","author":"C Martin-Villares","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"2","key":"pone.0261024.ref030","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/CCM.0000000000004752","article-title":"Early Percutaneous Tracheostomy in Coronavirus Disease 2019: Association With Hospital Mortality and Factors Associated With Removal of Tracheostomy Tube at ICU Discharge. A Cohort Study on 121 Patients","volume":"49","author":"A Rosano","year":"2021","journal-title":"Crit Care Med"},{"issue":"4","key":"pone.0261024.ref031","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1067\/mhn.2000.105714","article-title":"Tracheotomy Complications: A Retrospective Study of 1130 Cases","volume":"123","author":"D Goldenberg","year":"2000","journal-title":"Otolaryngol Neck Surg"},{"issue":"80","key":"pone.0261024.ref032","first-page":"239","article-title":"Base of Tongue Tuberculosis: A Case Report.","volume":"27","author":"CM Chiesa Estomba","year":"2015","journal-title":"Iran J Otorhinolaryngol"},{"key":"pone.0261024.ref033","article-title":"A hybrid approach to tracheostomy in COVID\u201019 patients ensuring staff safety","author":"L Tanaka","year":"2020","journal-title":"Br J Surg"},{"key":"pone.0261024.ref034","article-title":"Open tracheostomy for covid19 positive patients: a method to minimize aerosolization and reduce risk of exposure","author":"K Prabhakaran","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"pone.0261024.ref035","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.anorl.2020.05.006","article-title":"How and why use the EasyBreath\u00ae surface snorkeling mask as a personal protective equipment during the COVID-19 pandemic?","volume":"137","author":"B Thierry","year":"2020","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"issue":"3","key":"pone.0261024.ref036","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.anorl.2020.04.006","article-title":"French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic","volume":"137","author":"P Schultz","year":"2020","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"issue":"3","key":"pone.0261024.ref037","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","author":"L Angel","year":"2020","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"pone.0261024.ref038","doi-asserted-by":"crossref","first-page":"895","DOI":"10.4187\/respcare.02971","article-title":"Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion.","volume":"59","author":"NH Cheung","year":"2014","journal-title":"Respir Care"},{"issue":"12","key":"pone.0261024.ref039","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1097\/CCM.0000000000003368","article-title":"Laryngeal Injury and Upper Airway Symptoms after Oral Endotracheal Intubation with Mechanical Ventilation During Critical Care: A Systematic Review","volume":"46","author":"MB Brodsky","year":"2018","journal-title":"Crit Care Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T18:31:52Z","timestamp":1640197912000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261024"}},"subtitle":[],"editor":[{"given":"Sebastian","family":"Shepherd","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":39,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261024","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]}}}