Application of the Recommendations of the Brazilian Society of Thoracic Surgery for tracheostomy and airway management during the new coronavirus pandemic (COVID-19) in a hospital in the city of Vitória da Conquista - BA (PROTRAQUEO) / Aplicação das Recomendações da Sociedade Brasileira de Cirurgia Torácica para a traqueostomia e gestão das vias aéreas durante a nova pandemia de coronavírus (COVID-19) num hospital da cidade de Vitória da Conquista - BA (PROTRAQUEO)
DOI:
https://doi.org/10.34119/bjhrv4n6-230Keywords:
Tracheostomy, COVID-19, Recommendations, Brazilian Society of Thoracic Surgery.Abstract
The aim of this study was to investigate whether the recommendations of the Brazilian Society of Thoracic Surgery for tracheostomies and airway management during the COVID-19 pandemic are being correctly applied in a hospital in Bahia, Brazil. This is a cross-sectional study carried out between May and November 2020. The data sources were the responses to a data collection instrument made available to physicians and residents who agreed to participate in the study and signed the Informed Consent Form. In the total study sample, 36 procedures were collected between May and November 2020. Approximately 1/3 of the patients who underwent tracheostomy had a laboratory diagnosis of COVID-19 (33.3%). It was also observed that in 55.56% of the cases in the study, electric cutting and coagulation systems, ultrasonic or dispersed aerosol particles in the environment were used. In 58.33% of the cases, closed-circuit aspiration systems with antiviral filters were not used. Regarding the procedural measures expressed by the Brazilian Society of Thoracic Surgery (SBCT), 80.56% of the techniques developed in this sample followed all the steps of elective tracheostomy. In conclusion, tracheostomy and airway management during the new coronavirus pandemic at the hospital in question do not follow all the SBCT recommendations, a fact that poses a greater risk to the professionals and contacts involved. This finding may be a reflection of limited public resources, in addition to the lack of training and dissemination of recommendations to professionals.
References
Brazilian Society of Thoracic Surgery - SBCT (2020)1. Recommendations of the Brazilian Society of Thoracic Surgery - SBCT for performing tracheostomies and airway management in suspected or confirmed cases of infection by the new coronavirus (COVID-19). [posting on line]; 2020 [access on May 2, 2020]. Available at https://www.sbct.org.br/recomendacoes-da-sociedade-brasileira-de-cirurgia-toracica-sbct-para-realizacao-de-traqueostomias-e-manejo-da-via-aerea-em- suspected-or-confirmed-cases-of-new-coronavirus-c infection /
Federal University of Triângulo Mineiro - Hospital de Clínicas. Tracheostomy: Indications and guidelines for adult patient care [online publication]; 2020 [accessed on Feb 17, 2021]. Available at https://www.gov.br/ebserh/pt-br/hospitais-universitarios/regiao-sudeste/hc-uftm/documentos/protocolos-assistencial/traqueostomia-adulto-final.pdf
Sardenberg, Rodrigo Afonso da Silva; Avertano, Antonio Bomfim M, Younes Riad N. Percutaneous tracheostomy: ideal technique? Rev. Col. Bras. Cir [online magazine]. Rio de Janeiro, v. 38, no. 6, p. 435-439, Dec. 2011. accessed on May 16, 2020. Available at; <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S010069912011000600012&lng=en&nrm=iso>.
Tran Khai et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare professionals: a systematic review. PloS one [online magazine], v. 7, n. 4, 2012. Accessed on December 19, 2020. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035797
Loeb M, McGeer A, Henry B, et al. SARS among critical care nurses, Toronto. Emerg Infect Dis [online magazine] 2004; 10:251-5 Accessed Dec 15, 2020. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322898/
ENT UK (2020). Tracheostomy guidance during the COVID-19 Pandemic. [posting on line]; 2020 [access on May 2, 2020]. Available at: https://www.entuk.org/tracheostomy-guidance-during-covid-19-pandemic
Delgado Martín MC, et al. Consensus document of the Spanish Society of Intensive Care, Critical and Coronary Units (SEMICYUC), the Spanish Society of Otorhinolaryngology and Intensive Care. [online publication] 2020. [access on 08 Aug 2020] Available at: https://www.medintensiva.org/es-documento-consenso-sociedad-espanola-medicina-articulo-S0210569120301625
Brazilian Institute of Geography and Statistics [home page on the internet]. Population panorama. 2010 [accessed on March 3, 2021]. Available at: https://cidades.ibge.gov.br/brasil/ba/vitoria-da-conquista/panorama
McGrath BA, Brenner MJ, Warrillow SJ, et al. Tracheostomy in the COVID-19 was: global and multidisciplinary guidance. Lancet Respir Med. [online magazine] 2020; 8(7):717-725. doi:10.1016/S2213-2600(20)30230-7; Accessed January 12, 2021. Available at: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30230-7/fulltext
Ribeiro SC, Lauletta ALF, Franco BC, Bezerra RLA, Vanni DGBS, Baracat EC. Laparoscopic surgery and coronavirus disease: What do we know now?. Clinics (Sao Paulo) [online magazine]. 2020; 75:e2083. Accessed on January 11, 2021. Available at: https://www.scielo.br/j/clin/a/z7WZz9KtrhLNQLt8cgYrnXv/?lang=en
Qian Hua, Xiaohong Zheng.Ventilation control for airborne transmission of human exhaled bio-aerosols in buildings. Journal of Thoracic Disease[online journal]; 2018. V.19 P. 2295 – 2304. Accessed January 24, 2021. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6072925/pdf/jtd-10-S19-S2295.pdf
Li Y Leung, et al. Role of ventilation in airborne transmission of infectious agents in the built environment – A multidisciplinary systematic review. IndoorAir [online magazine]; 2007. Accessed on 29 Nov 2020. Available at: https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1600-0668.2006.00445.x
Chow TT, Kwan A, Lin Z, Bai, W. Conversion of operating theater from positive to negative pressure environment. 2006; Journal of Hospital Infection [reviewed online] 64 (4) 371–378; Accessed on 18 dec 2020. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114868/pdf/main.pdf
Mick P, Murphy R. Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic. A literature review. J Otolaryngol Head Neck Surg. 2020 [online magazine] ;49(1):29. Accessed January 17, 2021. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212733/pdf/40463_2020_Article_424.pdf
Pradhan D, Biswasroy P, Kumar Naik P, Ghosh G, Rath G. A Review of Current Interventions for COVID-19 Prevention. Arch Med Res. [online magazine] 2020; 51(5):363-374. Accessed January 21, 2021. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190516/pdf/main.pdf
Brewster DJ, Chrimes N, Do TB, et al. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med J Aust. [online magazine] 2020; 212(10):472-481. Accessed February 3, 2021. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267410/pdf/MJA2-212-472.pdf


