Tracheotomy In Patients With Covid-19
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Keywords
COVID-19, hemostasis, endotoxicosis, microcirculation, lipoperoxidation, tracheostomy
Abstract
Relevance. The coronavirus rush, which has appeared since December 2019, has an impact on economic, medical, and social development in all countries of the world. There are still no standard diagnostic and therapeutic plans aimed at limiting this infection.
Purpose. To determine the therapeutic role of tracheostomy with patients with coronavirus infection.
Material. The prospective study of 100 patients with coronavirus infection was carried out on the basis of State Budgetary Healthcare Institution “Interdistrict Multidisciplinary Hospital” in Nartkala city. When patients were admitted to the clinic, they were randomized into 2 groups depending on the therapy: the first group (comparison, n=50) – patients received traditional therapy in intensive care; the second (main, n=50) group – patients underwent tracheostomy in addition to standard therapy. The average age was 56.2±4.8 years. The women’s average age was 55 years (55.0%), and the men’s – 45 years (45.0%). Methods. Determination of the syndrome of endogenous intoxication, taxation of lipid peroxidation intensification. The local microcirculation was investigated by the apparatus LAKK-02. The activity of the coagulation-lytic blood system was found by thrombelastograph TEG® 5000.
Results. Early COVID-19 infection demonstrates signs of intoxication, oxidative depression, phospholipase
activity, microcirculatory and hemostatic disorders. These changes were the cause of the development of life-threatening complications (neurological, pulmonary, cardiac, etc.). They were associated with the type of treatment. Traditional treatment and the use of mask oxygen turned out to be ineffective, since the homeostasis system disorders remained throughout the investigation period. The inclusion of tracheostomy in traditional therapy makes it possible to quickly improve the course of pathology as it purposefully affects the pathogenetic links of the homeostasis system.
Conclusion. The use of tracheostomy in the scheme of standard treatment of coronavirus infection allows improving the effectiveness of general therapy of COVID-19 patients, especially with severe forms.
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