Raw Data for the article: Apneic Tracheostomy in COVID-19 Patients on Veno-Venous Extracorporeal Membrane Oxygenation

COVID-19 creates an impressive burden for intensive care units in terms of need for advanced respiratory care, with a huge number of acute respiratory distress syndromes (ARDS) requiring prolonged mechanical ventilation. In some cases, this proves to be insufficient, with a refractory respiratory failure calling for an extracorporeal approach (veno-venous ECMO). In this scenario, most of these patients need an early tracheostomy procedure to be carried out, which creates the risk of distribution of aerosol particles, possibly leading to personnel infection. The use of apneic tracheostomy has been proposed for COVID-19 patients, but in case of ECMO it may produce lung derecruitment, severe hypoxemia, and sudden worsening of respiratory mechanics. We developed an apneic tracheostomy technique and applied it in over 32 patients supported by veno-venous ECMO. We present data showing the safety and feasibility of this technique in terms of patient care and personnel protection. Gas exchange and pH did not show statistically significant changes after the tracheostomy, nor did respiratory mechanics data or the need for inspiratory pressure and FiO₂. The use of apneic tracheostomy was a safe option for patient care during ECMO and reduced the possibility of virus spreading.新型冠状病毒肺炎（COVID-19）给重症监护病房造成了沉重负担，其对高级呼吸支持的需求激增，大量急性呼吸窘迫综合征（Acute Respiratory Distress Syndrome，ARDS）患者需接受长期机械通气。 部分病例中，常规机械通气效果欠佳，难治性呼吸衰竭患者需采用体外生命支持手段，即静脉-静脉体外膜肺氧合（veno-venous ECMO）。在此临床场景下，此类患者多数需早期实施气管切开术，而该操作存在气溶胶播散风险，可能导致医护人员感染。 针对COVID-19患者，已有研究提出采用无呼吸气管切开术（apneic tracheostomy），但对于接受体外膜肺氧合支持的患者，该术式可能诱发肺复张不全、严重低氧血症及呼吸力学指标骤然恶化。本团队研发了一种无呼吸气管切开术术式，并将其应用于32余例接受静脉-静脉体外膜肺氧合支持的患者。 本研究展示了该术式在患者照护与医护人员防护层面的安全性与可行性数据：气管切开术后，患者的气体交换与血气pH值未出现具有统计学意义的显著变化，呼吸力学指标、吸气压力需求及吸入氧分数（Fraction of Inspired Oxygen，FiO₂）亦无明显改变。 在静脉-静脉体外膜肺氧合支持期间，采用无呼吸气管切开术是一种安全的患者照护方案，同时可降低病毒播散风险。