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Replacing ventilator with tracheotomy could help COVID-19 patients heal faster, UT Health study finds

COVID-19 patients were not used for the study, but researchers think the data applies

SAN ANTONIO – Having enough ventilators early on during the COVID-19 pandemic was a huge issue for cities and states, but then came the complications from using them so much.

According to UT Health San Antonio Intensive Specialist Dr. Alvaro Moreira, a ventilator can compromise patients who are critically ill.

“These individuals, because they are breathing with assisted ventilation, have an increased risk for developing pneumonia because your immune system is weakened. You have something that’s now foreign inside your body,” he says of the tubing used for ventilation.

What doctors have learned from a year of treating coronavirus patients, surviving the virus by using a ventilator often resulted in the need for long-term rehabilitation weeks or even months later. In fact, some are already seeing a year’s worth of breathing treatment after COVID.

Dr. Moreira’s research looked at 17 clinical trials and three-thousand patients around the world who suffered from critical illnesses like trauma and cancer. He evaluated whether choosing a tracheotomy early on instead of a ventilator for those who needed help breathing might have an impact on survival and recovery rates.

“When this was performed in a critically ill individual, we found that it not only decreased these individuals from getting ventilator-associated pneumonia, but it also decreased the duration of mechanical ventilation, as well as the total number of ICU days, all of which are really important for COVID,” he concluded.

It’s important to note that COVID-19 patients were not used for this research. They were not evaluated in part because initially there was fear that the procedure might easily spread the virus to the medical staff performing the procedure. Now the procedure has been modified with so that any aerosols from the patient can be contained during a tracheotomy.

“I understand is very daunting and scary for families. But if it can help them get home sooner, because if they were to get this pneumonia, then we know that it complicates their hospital stay and sometimes even can increase their mortality risk.”

The UT Health San Antonio study was published in the Journal of the American Medical Association Otolaryngology - Head and Neck Surgery. Dr. Moreira says the article is getting a lot of interest.

He notes that there is now a push, one year into the COVID pandemic for doctors to turn the page and start treating those with coronavirus in the same way as any other critically ill patient.

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