Bedside percutaneous tracheostomy experience with 72 critically ill patients

Abstract

Tracheostomy is necessary in intensive care unit (ICU) patients requiring prolonged mechanical ventilation. As an alternative to the standard surgical method, percutaneous techniques are available. Seventy-two patients were electively selected for percutaneous tracheostomy (PCT) in a nine-bed combined medical-surgical intensive care unit. PCT was performed at bedside with the Portex Percutaneous Tracheostomy Kit that uses the Griggs technique. The procedure time and early complications were recorded. The procedure was successful in all patients. The average duration of placement was 7.4 min. There were no tracheostomy-related deaths. Major bleeding occurred in three patients and required surgical intervention. In one patient, minor bleeding occurred at the stoma site that resolved with applied pressure. Wound infections were treated with local antiseptics in two patients. These findings suggest that PCT is a simple, quick and safe procedure.

Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study

“…Tracheostomy has several advantages over endotracheal intubation, including lower airway resistance, smaller dead space, less movement of the tube within the trachea, greater patient comfort and more efficient suction [4,5]. Although recent studies have suggested that tracheostomy can be a safe procedure in the ICU [6,7], tracheostomy has also been found to lead to serious complications, including tracheal stenosis, increased bacterial colonization and haemorrhage [8,9]. Many critically ill patients' families have been hesitant in authorizing tracheostomy because of cosmetic issues and speech problems.…”

Tracheal extubation under deep sevoflurane anesthesia: A novel strategy for weaning difficulties in intensive care

“…In a 3 - center clinical trial of early (within 48 hours) versus delayed (day 14-16) tracheostomy in 120 medical ICU patients, Rumbak et al ., found the duration of MV to be 7.6 ± 4 days in the early tracheostomy group as compared to 17.4 ± 5.3 days in the late tracheostomy group. [1] Exposure of our patient to this slow weaning process and the associated risks of tracheostomy (hemorrhage, misplacement, pneumothorax, subcutaneous emphysema, and tracheal or esophageal injury)[4] struck us as questionable in view of the fact that except for his airway irritability, the infective pathology had been successfully treated.…”

A Study of Role of Immediate Tracheostomy in Critically Ill Adult Patients in an Icu of Tertiary Hospital of Andhra Pradesh

“…2016;5(84):6249-6252, DOI: 10.14260/jemds/2016/1413 BACKGROUND Tracheostomy is required in critically ill patients to manage airway on a long term basis. 1 Indications of tracheostomy have not changed, but its timing has been questioned though shown to have definite effect on the outcome of the underlying disease. 2,3 Among the surgical procedures performed in critically ill patients in ICU setup tracheostomy accounts to 24%.…”