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Jun 20, 2024

When Is a Tracheostomy Used for COVID

Some people with serious COVID-19 who need a ventilator may have a tracheostomy. This involves the insertion of a breathing tube through an incision in your neck. It can improve some hospital-related

Some people with serious COVID-19 who need a ventilator may have a tracheostomy. This involves the insertion of a breathing tube through an incision in your neck. It can improve some hospital-related outcomes.

While many people that get COVID-19 have mild to moderate illness, some can become seriously ill. The individuals most at risk are those who:

It’s possible for some people with serious COVID-19 to need help breathing from a ventilator. At some point, these individuals may have a tracheostomy.

Keep reading to learn more about tracheostomies and COVID-19 as well as what to expect as far as the procedure, potential side effects, and your outlook.

Learn more about who’s most at risk of being hospitalized for COVID-19.

A tracheostomy is a procedure where a surgeon places a breathing tube directly into your trachea (windpipe) through an incision made in the front of your neck. The tracheostomy tube can be left open to the air or connected to a ventilator.

Tracheostomy can be used to:

There are two types of tracheostomy. A surgical tracheostomy is done in an operating room as an open surgery. A percutaneous tracheostomy can be done at your bedside in the hospital as a minimally invasive procedure.

Severe COVID-19 can lead to serious lung complications that can hamper your ability to breathe on your own. These are:

Because of this, some individuals who are seriously ill with COVID-19 need help breathing using a ventilator. Tracheostomy is often used when people need to use a ventilator over a prolonged period of time.

A 2021 study notes that previous research has shown that tracheostomy has the following medical benefits for people on a ventilator:

Earlier weaning can free up the ventilator and also help to move a person out of the intensive care unit (ICU). This was especially beneficial earlier in the pandemic when many ICUs were overwhelmed.

A tracheostomy is often done under general anesthesia. That means that you’ll be asleep during the procedure and won’t feel pain.

In emergency situations, tracheostomy may be done using a local anesthetic. In this scenario, you’ll be awake during the procedure but still won’t feel pain.

During the procedure, the surgeon will make an incision in the front of your neck through your skin and the cartilage of your trachea. The tracheostomy tube is then carefully inserted and secured into this incision.

If you need a tracheostomy due to COVID-19, hospital staff will help you to do the following:

Because most of the air you’re breathing will now pass through your tracheostomy tube, it can be challenging to speak. Some tracheotomy tubes have a “speaking valve” that helps with this.

It’s also likely you’ll have a feeding tube right after your tracheostomy. If you’re awake and alert, you may be able to start eating on your own. The specific types of food you can have generally depend on how well you can swallow.

When you’re able to breathe on your own, your tracheostomy tube may be removed. This is called decannulation.

After the tube is removed, the hole (stoma) will be covered with a bandage and left to heal. One 2022 study found that the median healing time was 6.5 days. Having a tracheostomy tube for longer was associated with increased healing times.

There are several potential side effects of having a tracheostomy. These include:

A 2022 report of 136 tracheostomies in people with COVID-19 noted bleeding as the most common complication. Collapsed lung was also reported.

Performing a tracheostomy generates aerosol particles. Because of this, there were also concerns that healthcare workers doing the procedure could be at risk of contracting SARS-CoV-2, the virus that causes COVID-19.

But, research has found that the risk to healthcare workers is low, provided that precautions, such as wearing appropriate personal protective equipment, are taken.

Some research has found that the timing of tracheostomy may be important. A 2020 study of people with COVID-19 on a ventilator found that the length of stay was shorter for those who had a tracheotomy earlier.

A 2022 review of 14 studies found that compared with later tracheostomy, early tracheostomy of people with severe COVID-19 was associated with a shorter time on a ventilator and a shorter ICU stay.

But, mortality was the same, regardless of when the tracheostomy was done.

A 2021 study found that, compared with surgical tracheostomy, people who had an early tracheostomy done through the skin (percutaneously) at the bedside and not during surgery had improved outcomes. These included:

Yes. Once your tracheostomy tube is removed and the area heals, you’ll have a small scar.

The best way to prevent having a tracheostomy due to COVID-19 is to take steps to prevent becoming ill. These include:

Some people needing prolonged ventilation for COVID-19 may have a tracheostomy. This is a procedure that allows you to receive oxygen through a breathing tube placed into your neck.

A tracheostomy can help people with serious COVID-19 by reducing the amount of time they depend on a ventilator. People receiving a tracheostomy may also have shorter stays in the ICU.