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2007, Number 4

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Rev Inst Nal Enf Resp Mex 2007; 20 (4)

Percutaneous dilational tracheostomy. Five years experience in a general critical care unit

Ramírez-Rosillo F, Santos-Martínez LE, Peña-Carrillo H, Leal-Gaxiola P, Contreras-Carreto NA, Remolina-Schling M

Language: Spanish
References: 16
Page: 241-246
PDF size: 105.12 Kb.


ABSTRACT

Tracheostomy is an invasive procedure to replace the endotracheal tube when mechanical ventilation extends beyond 21 days or when airway protection is desired in certain conditions. Tracheostomy can be performed by percutaneous methods, a technique that reduces the incidence of infection, bleeding, morbidity and mortality; also, it is a cost-effective alternative to surgical methods. We report our experience with this procedure in a general critical care unit.
Methods: During a 5 year period we studied patients who required percutaneous dilational tracheostomy (PDT) in a general critical care unit (GCCU). Demographic data, length of stay (LOS) at the GCCU, indications and complications of the technique were registered. The statistical data are expressed as their distribution sample. Friedman´s Anova for repeated measures was used. A p ‹ 0.05 was considered statistically significant.
Results: PDT was performed in 110 patients due to multiple trauma (10.9%), intra-cerebral hemorrhage (17.3%), ischemic stroke (18.1%), craneo-encephalic trauma (7.3%), severe pneumonia (27.3%), polyneuropathies (7.3%) and abdominal sepsis (11.8%). The median age was 65 (54, 75), 62.7% were male. There were 3 cases of bleeding and 2 with a false airway. The total LOS at the GCCU was 22 (15, 28) days; PDT was performed at the 14 (9, 18) day; patients were discharged 7 (4, 11) days after the procedure, p ‹ 0.0001.
Conclusions: PDT is safe procedure when performed at the GCCU. Complications were infrequent and patients could be discharged early after the procedure.


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