Panorama sobre las indicaciones, evolución y complicaciones de la traqueostomía en pacientes con COVID-19
Overview of the indications, evolution and complications of tracheostomy in patients with COVID-19

Diego Bratta, Adriana Sucunuta

Resumen


La pandemia de COVID-19 generada por el virus síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2), ocasionó la muerte a miles de personas a nivel mundial. Gran parte de los pacientes infectados por SARS-CoV-2, presentaron sintomatología limitada, no complicada. Sin embargo, otra pequeña porción de ellos, los pacientes críticos, requirieron el ingreso a la unidad de cuidados intensivos (UCI), para el manejo ventilatorio y algunos de ellos, ameritaron traqueostomía, luego de una ventilación mecánica invasiva prolongada. Tras el análisis de varios autores, las indicaciones para traqueostomía asociada a COVID-19, son similares a las indicaciones de traqueostomía establecidas previo a la pandemia, al igual que las complicaciones intraoperatorias tempranas, como hemorragia e infección en el sito de la lesión y complicaciones tardías relacionadas con la tonalidad de la voz. Esta revisión de la literatura tiene como objetivo especificar las indicaciones, evolución y complicaciones de la traqueostomía en pacientes con COVID-19. En la presente revisión narrativa se recolectaron artículos originales, revisiones sistémicas, revisiones bibliográficas y narrativas de las bases de datos PubMed y Biblioteca virtual en salud y las bases de datos Medline y LILACS. Se obtuvieron 27 artículos que cumplieron con el propósito del trabajo. El panorama de la traqueostomía no está claro, ya que a pesar que se han establecido un sin número de guías para el manejo, no existen consensos absolutos de las pautas. Por tal motivo, es mandatorio la clínica del paciente, sus comorbilidades, la accesibilidad de medicamentos, equipos de protección, e insumos médicos

ABSTRACT:

The COVID-19 pandemic generated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, caused the death of thousands of people worldwide. Most of the patients infected by SARS-CoV-2 presented limited, uncomplicated symptoms. However, another small portion of them, critically ill patients, required admission to the intensive care unit (ICU) for ventilatory management and some of them required tracheostomy after prolonged invasive mechanical ventilation. After analysis by several authors, the indications for tracheostomy associated with COVID-19 are similar to the indications for tracheostomy established prior to the pandemic, as are early intraoperative complications, such as hemorrhage and infection at the site of the injury and late complications related to the tonality of the voice. This literature review aims to specify the indications, evolution, and complications of tracheostomy in patients with COVID-19. In this narrative review, original articles, systemic reviews, bibliographic and narrative reviews were collected from the PubMed and Virtual Health Library databases and the Medline and LILACS databases. 27 articles that met the purpose of the work were obtained. The panorama of tracheostomy is not clear, since despite the fact that a number of guidelines for management have been established, there is no absolute consensus on the guidelines. For this reason, the patient's clinic, their comorbidities, the accessibility of medications, protective equipment, and medical supplies are mandatory.

DOI:

https://doi.org/10.53766/GICOS/2023.08.02.03


Palabras clave


COVID-19, traqueostomía, indicaciones, complicaciones, cuidados intensivos. tracheostomy, indications, complications, intensive care.

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Referencias


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