FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3129173841> ?p ?o ?g. }

• W3129173841 abstract "Abstract Background The COVID-19 pandemic has strained intensive care unit (ICU) resources. Tracheotomy is the most frequent surgery performed on ICU patients and can affect the duration of ICU care. We studied the association between when tracheotomy occurs and weaning from mechanical ventilation, mortality, and intraoperative and postoperative complications. Methods Multicentre prospective cohort including all COVID-19 patients admitted to ICUs in 36 hospitals in Spain who received invasive mechanical ventilation and tracheotomy between 11 March and 20 July 2020. We used a target emulation trial framework to study the causal effects of early (7 to 10 days post-intubation) versus late (>10 days) tracheotomy on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Cause-specific Cox models were used for the first two outcomes and Poisson regression for the third, all adjusted for potential confounders. Findings We included 696 patients, of whom 142 (20·4%) received early tracheotomy. Using late tracheotomy as the reference group, multivariable cause-specific analysis showed that early tracheotomy was associated with faster post-tracheotomy weaning (fully adjusted hazard ratio (HR) [95% confidence interval (CI)]: 1·31 [1·02 to 1·81]) without differences in mortality (fully adjusted HR [95% CI]: 0·91 [0·56 to 1·47]) or intraoperative or postoperative complications (adjusted rate ratio [95% CI]: 0·21 [0·03 to 1·57] and 1·49 [0·99 to 2·24], respectively). Interpretation Early tracheotomy reduced post-tracheotomy weaning time, resulting in fewer mechanical ventilation days and shorter ICU stays, without changing complication or mortality rates. These results support early tracheotomy for COVID-19 patients when clinically indicated. Funding Supported by the NIHR, FAME, and MRC. Research in context Evidence before this study The optimal timing of tracheotomy for critically ill COVID-19 patients remains controversial. Existing guidelines and recommendations are based on limited experiences with SARS-CoV-1 and expert opinions derived from situations that differ from a pandemic outbreak. Most of the available guidance recommends late tracheotomy (>14 days), mainly due to the potential risk of infection for the surgical team and the high patient mortality rate observed early in the first wave of the COVID-19 pandemic. Recent publications have shown that surgical teams can safely perform tracheotomies for COVID-19 patients if they use adequate personal protective equipment. Early tracheotomy seems to reduce the length of invasive mechanical ventilation without increasing complications, which may release crucial intensive care unit (ICU) beds sooner. The current recommendations do not suggest an optimal time for tracheotomy for COVID-19 patients, and no study has provided conclusions based on objective clinical parameters. Added value of this study This is the first study aiming to establish the optimal timing for tracheotomy for critically ill COVID-19 patients requiring invasive mechanical ventilation (IMV). The study prospectively recruited a large multicentre cohort of 696 patients under IMV due to COVID-19 and collected data about the severity of respiratory failure, clinical and ventilatory parameters, and whether patients need to be laid flat during their ICU stay (proned). The analysis focused on the duration of IMV, mortality, and complication rates. We used a prospective cohort study design to compare the ‘exposures’ of early (performed at day 7 to 10 after starting IMV) versus late (performed after day 10) tracheotomy and set the treatment decision time on the 7th day after orotracheal intubation. Implications of all the available evidence The evidence suggests that tracheotomy within 10 days of starting COVID-19 patients on mechanical ventilation allows these patients to be removed from ventilation and discharged from ICU quicker than later tracheotomy, without added complications or increased mortality. This evidence may help to release ventilators and ICU beds more quickly during the pandemic." @default.
• W3129173841 created "2021-02-15" @default.
• W3129173841 creator A5003943367 @default.
• W3129173841 creator A5007968730 @default.
• W3129173841 creator A5013225468 @default.
• W3129173841 creator A5019354347 @default.
• W3129173841 creator A5029387547 @default.
• W3129173841 creator A5029663927 @default.
• W3129173841 creator A5029781406 @default.
• W3129173841 creator A5031150316 @default.
• W3129173841 creator A5037381322 @default.
• W3129173841 creator A5038076932 @default.
• W3129173841 creator A5050508542 @default.
• W3129173841 creator A5058357487 @default.
• W3129173841 creator A5059110973 @default.
• W3129173841 creator A5061103007 @default.
• W3129173841 creator A5061611463 @default.
• W3129173841 creator A5068974561 @default.
• W3129173841 creator A5069313803 @default.
• W3129173841 creator A5071481515 @default.
• W3129173841 creator A5078233515 @default.
• W3129173841 creator A5079861656 @default.
• W3129173841 creator A5080513072 @default.
• W3129173841 creator A5088749554 @default.
• W3129173841 date "2021-01-30" @default.
• W3129173841 modified "2023-10-18" @default.
• W3129173841 title "Timing of elective tracheotomy and duration of mechanical ventilation amongst patients admitted to intensive care with severe COVID-19: a multicentre prospective cohort study" @default.
• W3129173841 cites W1903005360 @default.
• W3129173841 cites W1965663028 @default.
• W3129173841 cites W1998118136 @default.
• W3129173841 cites W2063867291 @default.
• W3129173841 cites W2097764206 @default.
• W3129173841 cites W2111714917 @default.
• W3129173841 cites W2118502261 @default.
• W3129173841 cites W2137621080 @default.
• W3129173841 cites W2165254830 @default.
• W3129173841 cites W2298338128 @default.
• W3129173841 cites W2341341750 @default.
• W3129173841 cites W3008827533 @default.
• W3129173841 cites W3011611380 @default.
• W3129173841 cites W3013274830 @default.
• W3129173841 cites W3014922871 @default.
• W3129173841 cites W3016727837 @default.
• W3129173841 cites W3017592677 @default.
• W3129173841 cites W3025817904 @default.
• W3129173841 cites W3031329400 @default.
• W3129173841 cites W3089673109 @default.
• W3129173841 cites W3097863232 @default.
• W3129173841 cites W3110492449 @default.
• W3129173841 cites W4292229870 @default.
• W3129173841 doi "https://doi.org/10.1101/2021.01.22.21249651" @default.
• W3129173841 hasPublicationYear "2021" @default.
• W3129173841 type Work @default.
• W3129173841 sameAs 3129173841 @default.
• W3129173841 citedByCount "2" @default.
• W3129173841 countsByYear W31291738412022 @default.
• W3129173841 crossrefType "posted-content" @default.
• W3129173841 hasAuthorship W3129173841A5003943367 @default.
• W3129173841 hasAuthorship W3129173841A5007968730 @default.
• W3129173841 hasAuthorship W3129173841A5013225468 @default.
• W3129173841 hasAuthorship W3129173841A5019354347 @default.
• W3129173841 hasAuthorship W3129173841A5029387547 @default.
• W3129173841 hasAuthorship W3129173841A5029663927 @default.
• W3129173841 hasAuthorship W3129173841A5029781406 @default.
• W3129173841 hasAuthorship W3129173841A5031150316 @default.
• W3129173841 hasAuthorship W3129173841A5037381322 @default.
• W3129173841 hasAuthorship W3129173841A5038076932 @default.
• W3129173841 hasAuthorship W3129173841A5050508542 @default.
• W3129173841 hasAuthorship W3129173841A5058357487 @default.
• W3129173841 hasAuthorship W3129173841A5059110973 @default.
• W3129173841 hasAuthorship W3129173841A5061103007 @default.
• W3129173841 hasAuthorship W3129173841A5061611463 @default.
• W3129173841 hasAuthorship W3129173841A5068974561 @default.
• W3129173841 hasAuthorship W3129173841A5069313803 @default.
• W3129173841 hasAuthorship W3129173841A5071481515 @default.
• W3129173841 hasAuthorship W3129173841A5078233515 @default.
• W3129173841 hasAuthorship W3129173841A5079861656 @default.
• W3129173841 hasAuthorship W3129173841A5080513072 @default.
• W3129173841 hasAuthorship W3129173841A5088749554 @default.
• W3129173841 hasBestOaLocation W31291738411 @default.
• W3129173841 hasConcept C126322002 @default.
• W3129173841 hasConcept C141071460 @default.
• W3129173841 hasConcept C177713679 @default.
• W3129173841 hasConcept C188816634 @default.
• W3129173841 hasConcept C207103383 @default.
• W3129173841 hasConcept C2776376669 @default.
• W3129173841 hasConcept C2777080012 @default.
• W3129173841 hasConcept C2778551211 @default.
• W3129173841 hasConcept C42219234 @default.
• W3129173841 hasConcept C44249647 @default.
• W3129173841 hasConcept C71924100 @default.
• W3129173841 hasConceptScore W3129173841C126322002 @default.
• W3129173841 hasConceptScore W3129173841C141071460 @default.
• W3129173841 hasConceptScore W3129173841C177713679 @default.
• W3129173841 hasConceptScore W3129173841C188816634 @default.
• W3129173841 hasConceptScore W3129173841C207103383 @default.
• W3129173841 hasConceptScore W3129173841C2776376669 @default.
• W3129173841 hasConceptScore W3129173841C2777080012 @default.
• W3129173841 hasConceptScore W3129173841C2778551211 @default.
• W3129173841 hasConceptScore W3129173841C42219234 @default.

• next