The Comparative Changes in Inflammatory Markers Between Fiber Optic Bronchoscopy Guided and Classical Percutaneous Dilatational Tracheostomy

Abstract

Aim: Approximately ¼ of mechanically ventilated patients undergo tracheostomy in the intensive care units and percutaneous dilatational tracheostomy (PDT) replaces traditional open surgical tracheostomy. Various studies compare tracheostomy techniques according to safety, efficacy and cost affectivity. The biomarkers are used to reflect systemic acute-phase reaction (APR) which is in accordance with the severity of the tissue trauma. In the present study, we aimed to describe APR in patients undergoing PDT with or without bronchoscopy guidance, by analyzing changes in chosen inflammatory biomarkers. Study design: This single-center, retrospective descriptive study of 231 patients who underwent PDT was conducted between July 2016 and December 2018, in our tertiary ICU. Materials and Methods: The demographic data, the clinical outcomes and inflammatory biomarkers before and after PDT were derived from the hospital's database. All statistical analyses were performed with SPSS version 24 and for all analyses, a p-value ≤ 0.05 was regarded as statistically significant. Results: In this study, we compared the acute phase reaction caused by Fiber Optic Bronchoscopy Guided PDT and Classical PDT using inflammatory markers. Although the length of hospital and intensive care unit stay was longer with the guidance of bronchoscopy, the difference was not statistically significant between groups. In terms of inflammatory markers, the difference between the groups was found statistically significant. Conclusion: PDT was compared to open surgical tracheostomy (OST) largely in the literature and it was found less inflammation-related while we found that FOB guidance related less inflammatory response and the relative changes in APR were less.