Modified percutaneous tracheostomy in COVID‐19 critically ill patients

Vargas, Maria; Russo, Gennaro; Iacovazzo, Carmine; Servillo, Giuseppe

BACKGROUND: Percutaneous tracheostomy (PT) in patients with coronavirus disease (COVID‐19) included several critical steps associated with increased risk of aerosol generation. We reported a modified PT technique aiming to minimize the risk of aerosol generation and to increase the staff safety in COVID‐19 patients. METHODS: PT was performed with a modified technique including the use of a smaller endotracheal tube (ETT) cuffed at the carina during the procedure. RESULTS: The modified technique we proposed was successfully performed in three critically ill patients with COVID‐19. CONCLUSIONS: In COVID‐19 critically ill patients, a modified PT technique, including the use of a smaller ETT cuffed at the carina and fiber‐optic bronchoscope inserted between the tube and the inner surface of the trachea, may ensure a better airway management, respiratory function, patient comfort, and great safety for the staff.