Background: Coronavirus disease 2019 (COVID-19) is a highly contagious disease that causes respiratory failure. Tracheostomy is an essential procedure in critically ill COVID-19 patients; however, it is an aerosol-generating technique and thus carries the risk of infection transmission. We report our experience with percutaneous tracheostomy and its safety in a real medical setting. Methods: During the COVID-19 outbreak, 13 critically ill patients were admitted to the intensive care unit (ICU) at Daegu Catholic University Medical Center between February 24 and April 30, 2020. Seven of these patients underwent percutaneous tracheostomy using Ciaglia Blue Rhino. The medical environment, percutaneous tracheostomy method, and COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results were retrospectively reviewed. After treatment, the COVID-19 infection status of healthcare personnel was investigated by RT-PCR. Results: The ICU contained negative pressure cohort areas and isolation rooms, and healthcare personnel wore a powered air-purifying respirator system. We performed seven cases of percutaneous tracheostomy in the same way as in patients without COVID-19. Five patients (71.4%) tested positive for COVID-19 by RT-PCR at the time of tracheostomy. The median cycle threshold value for the RNA-dependent RNA polymerase was 30.60 (interquartile range [IQR], 25.50–36.56) in the upper respiratory tract and 35.04 (IQR, 28.40–36.74) in the lower respiratory tract. All healthcare personnel tested negative for COVID-19 by RT-PCR. Conclusions: Percutaneous tracheostomy was performed with conventional methods in the negative pressure cohort area. It was safe to perform percutaneous tracheostomy in an environment of COVID-19 infection.
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机译：背景：2019年冠状病毒疾病（Covid-19）是一种高度传染性的疾病，导致呼吸衰竭。气管造口术是批评性患者的重要程序;然而，它是一种气溶胶产生技术，因此承载感染传输的风险。我们在实际医疗环境中报道了我们用经皮气管造口术及其安全的经验。方法：在Covid-19爆发期间，在2月24日和4月30日期间，在Daegu天主教大学医疗中心的重症监护室（ICU）中，13名批判性患者均已达到2020年4月30日。这些患者中的七名患者经常使用Ciaglia Blue Rhina经过皮革管制术。回顾性审查了医疗环境，经皮气管造口术方法和Covid-19逆转录酶链反应（RT-PCR）结果。治疗后，通过RT-PCR研究了医疗保健人员的Covid-19感染状况。结果：ICU含有负压队列区域和隔离室，医疗保健人员佩戴了一种动力的空气净化呼吸器系统。我们以与没有Covid-19的患者的患者相同的方式进行了7例皮革气管造口术。在气管造口术时，将五名患者（71.4％）通过RT-PCR测试Covid-19阳性。 RNA依赖性RNA聚合酶的中值循环阈值为30.60（中呼吸道的上呼吸道和35.04（IQR，28.40-36.74）中的25.04（IQR，28.40-36.74）。所有医疗保健人员通过RT-PCR测试了Covid-19的阴性。结论：用负压队列地区的常规方法进行经皮气管造口术。在Covid-19感染的环境中进行经皮气管造口术是安全的。
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