key: cord-0730859-u8aq5oxo
authors: Ahmed, Yasmina; Cao, Angela; Thal, Arielle; Shah, Sharan; Mehta, Vikas; Ow, Thomas; Smith, Richard; Schiff, Bradley A.
title: In Response to Improving the Safety and Science of COVID‐19 Tracheostomy: Challenges and Opportunities
date: 2021-03-16
journal: Laryngoscope
DOI: 10.1002/lary.29520
sha: 46299da11e0d7c5eac909eab55c34653f066c9ab
doc_id: 730859
cord_uid: u8aq5oxo

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In Response to Improving the Safety and Science of COVID-19 Tracheostomy: Challenges and Opportunities

In Reply:

We appreciate the thoughtful comments of Dr. Brenner et al. and fully agree with the issues they raise. Our paper covered one institution's data on COVID-19 related tracheostomies 1 performed at the start of the pandemic in the northeast. At that time little data existed on the ideal timing of tracheostomy in COVID-19 positive patients, and the risk these tracheostomies presented to providers. The information we used to determine our timing and indications for tracheostomy on the patients included in the study were initial reports or guidelines based on limited data. 2, 3 Early in the pandemic scarce resources and unclear risk to providers, coupled with early reports of very high morbidity in intubated COVID-19 positive patients, led to initial caution in performing tracheostomy. However, as our experience, and other studies, demonstrated minimal risk to properly protected providers, and advances in patient care led to improved outcomes, we gradually shifted toward earlier tracheostomy in COVID-19 positive patients. [4] [5] [6] [7] We completely agree that collecting prospective data is critical to our ultimate success in treating COVID-19 positive patients. Going forward we will need more than retrospective single institution studies to determine the ideal role and timing of tracheostomy in COVID-19 positive patients. 

Tracheotomy outcomes in 64 ventilated COVID-19 patients at a high-volume

AAO-HNS tracheotomy recommendations during the COVID-19 pandemic

Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak

Tracheotomy in a high-volume center during the COVID-19 pandemic: evaluating the surgeon's risk. Otolaryngology-Head and Neck

Improving survival of critical care patients with coronavirus disease 2019 in England: a National Cohort Study

Covid-19 and ENT practice: our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic

Safety and prognosis in percutaneous vs surgical tracheostomy in 27 patients with COVID-19

Send correspondence to Bradley Schiff, MD, 3400 Bainbridge Ave, 3rd Floor MAP Bldg

The authors have no funding, financial relationships, or conflicts of interest to disclose.