Elective open tracheostomy for patients under prolonged mechanical ventilation—a study

Abstract

Objective To determine the safety of elective open tracheostomy as a routine intensive care unit (ICU) procedure without any selection criteria, considering its peri-and postoperative complications.Materials and methods This is a descriptive study conducted in two hospitals in Davangere for a period of three years between April 2005 and March 2008. 40 patients, both male and female, of all age groups who were under mechanical ventilation in whom open tracheostomy was performed were included in the study. All patients who recovered were followed-up for two months. Complications arising during this period were recorded in the proforma.Results Our study consisted of 40 patients comprising 30 males and 10 females with male to female ratio of 3:1 and average age of 35 years, all undergoing open tracheostomy for prolonged mechanical ventilation. Various indications for mechanical ventilation included polytrauma, head injury, septicemia with multiorgan failure and dengue encephalitis. The complications which arised during the procedure and follow-up period included cardiac arrest, surgical emphysema, reactionary hemorrhage, pneumothorax, tracheocutaneous fi stula, tracheo-oesophageal fi stula. ConclusionElective open tracheostomy seems to be a safe and simple procedure, when performed by experienced surgeon under controlled circumstances, and should be considered as an option for mechanically ventilated patients.

Indications And Outcomes Of Tracheostomy In Northern Ghana

“…In this study, majority of the patients were males and the peak incidence was in the fourth decade, which is similar in comparison to other studies despite varying backgrounds of the studies 6,7,11,[13][14][15] . The peak incidence, however had some disparities; it was similar to studies in developing countries like Nigeria and Tanzania 7,14 ; where peak incidences were between the 3 rd and 5 th decades) but varied with findings in other studies elsewhere 5,6,11,13 . The latter variation may probably be due to the different sociocultural backgrounds of the study populations.…”

“…Recent publications, however, have shown a drastic change in the trends with trauma and prolonged intubation replacing upper airway obstruction due to acute infections as the most common indications for tracheostomy [4][5][6][8][9][10][11][12] ). The reason for this is the changes in epidemiology of infectious diseases due to early diagnosis, adequate use of antibiotics and the improvement in medical care 13 .…”