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Ultima descărcare din IBN: 2023-12-22 10:05 |
SM ISO690:2012 CÎVÎRJIC, Ivan, COBÎLEŢCHI, Sergiu, CRIVORUCICA, Veaceslav, BALTAGA, Ruslan. Traheostomie percutană apneică cu ghidaj ultrasonografic la pacienți COVID-19 . In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 400. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | |||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | |||||
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Background. Approximately 12-15% of COVID-19 patients require invasive ventilation by tracheal intubation, and up to 5% of them are tracheostomised. The application of tracheostomy to critical ill COVID19 patients, being an aerosol-producing procedure, presents a high risk of contamination for medical staff. Objective of the study. Development and evaluation of a safe percutaneous tracheostomy technique both for critical ill COVID-19 patients in order to minimize peri-procedural complications and for medical staff in order to minimize the risk of contamination. Material and Methods. In a pilot study, out of the total number of 77 critical ill COVID-19 patients, hospitalized in the intensive care unit of Institute of Emergency Medicine between April 2 and May 18, 2020, with severe respiratory failure, that required prolonged artificial ventilation, 15 patients were selected eligible for whom percutaneous tracheostomy by ultrasound-guided apnea method was applied. Results. The procedure was successfully applied to 15patients.Average duration of apnea120sec(ampl.30sec).Minimum level of SpO2 during apnea-75%(ampl.15%).Peri-procedural complications recorded:hemorrhage, stopped with the installation of the tracheostomy tube-1case and difficulty in puncture of trachea due to the association in the patient of morbid obesity and BMI>35,with the decrease of SpO2 between the values of 40-60%,without bradycardization-1case.Out of the total number,8patients were weaned from the ventilator and transferred to the therapeutic department,7died.The average duration of the ventilator support was-20days(ampl.5days).No team members were infected during the pilot study. Conclusion. In the context of the COVID-19 pandemic, ultrasound guided percutaneous apnea tracheostomy may be an alternative surgical technique, safe for both COVID-19 critical ill patients and medical staff, but more detailed and larger studies are needed. |
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Cuvinte-cheie tracheostomy, percutaneous, ultrasound, apnea, COVID-19, traheostomie, percutană, ultrasonografic, apneică, COVID-19 |
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