key: cord-0844849-j8llhlq2
authors: Pichi, Barbara; Mazzola, Francesco; Bonsembiante, Anna; Petruzzi, Gerardo; Zocchi, Jacopo; Moretto, Silvia; De Virgilio, Armando; Pellini, Raul
title: Reply to ‘CORONA-steps for tracheotomy in COVID-19 patients: a staff-safe method for airway management’ by Ferreli F. et al
date: 2020-04-27
journal: Oral Oncol
DOI: 10.1016/j.oraloncology.2020.104743
sha: 555f339df2e17f732636a817b974bfbb15295b1a
doc_id: 844849
cord_uid: j8llhlq2

nan

We sincerely appreciate the interest of Ferreli et al. in our study and we are grateful for the invaluable comments and feedback which have allowed us to respond with some clarifications. 1

The reply of Ferreli et al. is merely focused on the timing of the tracheotomy, which actually is a marginal aspect of the editorial letter by Pichi et al. 2 Indeed, the intent of the publication was to provide information to safeguard the operators performing tracheotomy. In addition to this, Ferreli et al. support their personal thesis claiming that in a recent retrospective study including 1591 COVID-19 positive patients admitted to the ICU, the median length of ICUstay was only 9 days (range: 6-13). However, it should be noted that at the last follow-up, 58% of the patients were still admitted in the ICU and consequently the statistical analysis is not representative of the whole sample. 6 Finally, Ferreli et. al. cited the experience of a center reporting that no tracheotomies have been performed without any data supporting their thesis (complication rates, intubation duration, ICU median stay, mortality). Even less clear is the cited reference between medulla oblongata involvement, COVID-19 infection and tracheotomy timing. 7 Having said that, given that the COVID-19 pandemic puts us in a pathless and convulsive situation, in which things change very quickly, and in the absence of reliable data, where what is considered true today can be denied by new facts tomorrow, pending new facts it is worth taking into account the older.

CORONA-steps for tracheotomy in COVID-19 patients: a staff-safe method for airway management

CORONA-steps for tracheotomy in COVID-19 patients: a staff-safe method for airway management

Timing of tracheostomy in patients with prolonged endotracheal intubation: a systematic review

Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial

Baseline Characteristics and Outcomes of 1591

Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA

The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients