Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society.
- Piazza C Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, Via Giacomo Venezian 1, 20133, Milan, Italy.
- Filauro M Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy. mfilauro@yahoo.com.
- Dikkers FG Department of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Nouraei SAR The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, Poole, UK.
- Sandu K Department of Otorhinolaryngology, Lausanne University Hospital CHUV, 1011, Lausanne, Switzerland.
- Sittel C Department of Otorhinolaryngology, Head and Neck Surgery, Katharinenhospital, Kriegsbergstrasse 60, 70174, Stuttgart, Germany.
- Amin MR Department of Otolaryngology, Head and Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA.
- Campos G Department of Surgery, Instituto de Laringologia, Fundacion Santa Fe University Hospital, Bogotà , DC, Colombia.
- Eckel HE Department of Otorhinolaryngology, Klagenfurt General Hospital, Feschnigstrasse 11, 9026, Klagenfurt am Worthersee, Austria.
- Peretti G Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
- 2020-06-08
Published in:
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. - 2020
Airway team
COVID-19
European laryngological society
Intubation injuries
Laryngotracheal stenosis
Prevention
Tracheostomy
English
INTRODUCTION
The novel Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, may need intensive care unit (ICU) admission in up to 12% of all positive cases for massive interstitial pneumonia, with possible long-term endotracheal intubation for mechanical ventilation and subsequent tracheostomy. The most common airway-related complications of such ICU maneuvers are laryngotracheal granulomas, webs, stenosis, malacia and, less commonly, tracheal necrosis with tracheo-esophageal or tracheo-arterial fistulae.
MATERIALS AND METHODS
This paper gathers the opinions of experts of the Laryngotracheal Stenosis Committee of the European Laryngological Society, with the aim of alerting the medical community about the possible rise in number of COVID-19-related laryngotracheal stenosis (LTS), and the aspiration of paving the way to a more rationale concentration of these cases within referral specialist airway centers.
RESULTS
A range of prevention strategies, diagnostic work-up, and therapeutic approaches are reported and framed within the COVID-19 pandemic context.
CONCLUSIONS
One of the most important roles of otolaryngologists when encountering airway-related signs and symptoms in patients with previous ICU hospitalization for COVID-19 is to maintain a high level of suspicion for LTS development, and share it with colleagues and other health care professionals. Such a condition requires specific expertise and should be comprehensively managed in tertiary referral centers.
The novel Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, may need intensive care unit (ICU) admission in up to 12% of all positive cases for massive interstitial pneumonia, with possible long-term endotracheal intubation for mechanical ventilation and subsequent tracheostomy. The most common airway-related complications of such ICU maneuvers are laryngotracheal granulomas, webs, stenosis, malacia and, less commonly, tracheal necrosis with tracheo-esophageal or tracheo-arterial fistulae.
MATERIALS AND METHODS
This paper gathers the opinions of experts of the Laryngotracheal Stenosis Committee of the European Laryngological Society, with the aim of alerting the medical community about the possible rise in number of COVID-19-related laryngotracheal stenosis (LTS), and the aspiration of paving the way to a more rationale concentration of these cases within referral specialist airway centers.
RESULTS
A range of prevention strategies, diagnostic work-up, and therapeutic approaches are reported and framed within the COVID-19 pandemic context.
CONCLUSIONS
One of the most important roles of otolaryngologists when encountering airway-related signs and symptoms in patients with previous ICU hospitalization for COVID-19 is to maintain a high level of suspicion for LTS development, and share it with colleagues and other health care professionals. Such a condition requires specific expertise and should be comprehensively managed in tertiary referral centers.
- Language
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- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1007/s00405-020-06112-6
- PMID 32506145
- Persistent URL
- https://sonar.ch/global/documents/13301
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