‘Early tracheostomy in severe COVID-19 patients will help’

Experts say it can save lung of critically-ill person

Doctors at MIOT International have found that early tracheostomy in young patients diagnosed with severe COVID-19 was key for better outcomes.

According to a press release, the hospital said that COVID-19 causes reduction in the elasticity of the lungs. This would result in an increased build-up of carbon dioxide in the body, leading to poor outcome for COVID-19.

It has been observed that the severity of COVID-19 was more common in persons in their 20s, 30s and 40s. Research papers published in international journals pointed towards an unique approach - early tracheostomy, and experts recommend tracheostomy over ECMO (Extra Corporeal Membrane Oxygenation) to save the lung when a critically-ill patient is at the cusp of retaining carbon dioxide.

The hospital has come up with this approach where young patients, who had severe COVID-19, were advised intervention before the lungs become stiff. The patient is directly offered tracheostomy – an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube.

The advantages included identifying organisms that could cause opportunistic infection in the lung so that the health of the lung could be restored sooner, the hospital release said. Moreover, they were less expensive with less co-morbidities compared to other modalities of treatment. The success rate was 85% with a reduced hospital stay of 21 days, it added.

“We found that comparatively more patients in the second wave were proceeding to respiratory failure on non-invasive ventilation and retaining carbon dioxide. With early tracheostomy, we were able to support the patient better and also lower the dose of steroid to prevent opportunistic infection as well as lower the dose of blood thinners thereby reducing the risk of bleeding,” Prithvi Mohandas, managing director, MIOT International, said.

The release cited a study in Sweden that indicated early tracheostomy (5 to 28 days) was related to a reduced need for mechanical ventilation and a shorter duration of stay in the Intensive Care Unit in cases of severe COVID-19.