We read the letter to the editor by Brenner et al (1) in response to our article (2) with great interest published in Critical Care Medicine. We appreciate the comments made by the letter’s authors, and we would like to address their main points:
1) We agree that clinical bias was present in the selection of candidates for this procedure given the overall circumstances and the inability to conduct a large randomized study; therefore, the propensity score matching was the best available option to minimize bias as much as possible.
2) We acknowledge that long-term effects of critical illness and ICU care including mechanical ventilation, neuromuscular blockade, sedation…etc and their effects on quality of life in coronavirus disease 2019 (COVID-19) survivors are the most major endpoints to be followed. These data continue to be tracked, and we are planning on following with a long-term survivorship outcome study in the near future to answer these questions.
3) We hope that our novel percutaneous tracheostomy approach along with further cumulative data from other centers will help guide current practices in early tracheostomy for COVID-19 respiratory failure and provide a blueprint for potential future pandemics given the demonstrated safety to staff and reduced risk for apnea-induced de-recruitment for patients.
Footnotes
Dr. Rafeq received funding from Boston Scientific, Cook, and Intuitive Surgical. Dr. Angel has disclosed that he does not have any potential conflicts of interest.
REFERENCES
- 1.Brenner MJ, Feller-Kopman DJ, Pelosi P: Coronavirus Disease 2019 Tracheostomy Candidacy, Ceteris Paribus Assumptions, and Tracking Survivorship Data. Crit Care Med. 2022; 50:e320–e321 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Angel L, Amoroso NE, Rafeq S, et al. : Percutaneous dilational tracheostomy for coronavirus disease 2019 patients requiring mechanical ventilation. Crit Care Med. 2021; 49:1058–1067 [DOI] [PubMed] [Google Scholar]