[Impact of the COVID-19 pandemic on percutaneous tracheostomy practice: an eight-year analysis in an intensive care unit].

INTRODUCTION

Percutaneous tracheostomy (PcT) is a common procedure in intensive care units, particularly among patients requiring prolonged mechanical ventilation. The COVID-19 pandemic substantially modified airway management practices, although evidence characterizing these changes in Latin American settings remains limited.

MATERIALS AND

METHODS

This observational, retrospective study included adult patients who underwent PcT in the intensive care unit of a tertiary hospital between 2014 and 2021. Clinical characteristics and temporal trends were analyzed comparing the pre-pandemic period (2014-2019) and the pandemic period (2020-2021).

RESULTS

A total of 398 PcT were performed during the study period. The annual procedural volume increased by 106% during the pandemic period compared with the pre-pandemic period (81.5 vs. 39.2 procedures/year). During the pandemic period, COVID-19 emerged as the leading cause of invasive mechanical ventilation among patients undergoing PcT, accounting for 75.5% of cases in 2021 (p<0.001). The duration of mechanical ventilation prior to tracheostomy was longer during the pandemic period, with significant differences observed between 2019 and 2020 (p=0.028).

CONCLUSION

The COVID-19 pandemic was associated with an increased volume of PcT and a relevant etiological shift among critically ill patients undergoing this procedure. These findings highlight the need to adapt airway management and respiratory rehabilitation protocols during public health emergencies.