2020 Volume 71 Issue 6 Pages 426-433
We report the case of a 65-year-old male who was admitted to our hospital for COVID-19 pneumonia in the early stage of the epidemic. He was treated with tracheal intubation and mechanical ventilation on the 4th day in hospital. His respiratory function did not improve, however, and a tracheostomy was performed in the hospital's negative pressure room on the 16th day in hospital. A dual cannula tube was used for the tracheostomy tube. Management after surgery was performed with the appropriate standard precautions and additional precautions against aerosol infections in consultation with an infection control team. After surgery, the patient's respiratory condition improved and he was removed from the ventilator on the 35th day in hospital. The tracheostomy tube was changed to the speech type on the 38th day, and the tube was removed on the 45th day. In addition, after the tracheostomy a comprehensive evaluation was performed using the Kuchi-kara Taberu (KT) index to assess dysphagia rehabilitation, and on the 22nd day in hospital a small amount of food intake was started. After undergoing swallowing rehabilitation based on a plan, the nasal tube was removed on the 40th day. No nosocomial infections were observed in our medical staff or hospitalized patients during the course. For infection risk management after tracheostomy in patients with COVID-19 pneumonia, it is important to prevent contact infection, droplet infection and aerosol infection as the routes of infection. A dual cannula tube is considered useful for reducing aerosol generation during procedures such as tube replacement.
