Our Percutaneous Tracheostomy Experience in Our Intensive Care Unit: A Retrospective Analysis

Abstract

OZ. Amac: Yogun bakim unitemizde perkutan trakeostomi yontemi ile acilan 58 hastayi retrospektif olarak sunmayi amacladik. Materyal ve metod: Hastanemizin anesteziyoloji ve reanimasyon klinigi yogun bakim unitesinde Ocak 2017-Aralik 2020 tarihleri arasinda perkutan yontemle trakeostomi acilan hastalar retrospektif olarak incelendi. Bulgular: Calismaya 58 hasta dahil edildi. Hastalarin yas ortalamasi 65±18,2 yil idi. Hastalarin %56,9’i erkek, % 43,1’i kadindi. Yatis tanilarina bakildiginda en sik neden norolojik nedenler idi. Hastalarin Apache II skorlari ortalama 23,2±3,6 olarak bulundu. Hastalarin PT acilmasina kadar gecen sure ortalama 18,3±5,1 gun, PT acilma suresi 11,1±2,4 dk, mekanik ventilator sureleri 62,1±37,8 gun ve yogun bakim yatis suresi 67,2±43,5 gun olarak bulundu. Islem sirasinda en sik gorulen komplikasyon hipoksi ve hipotansiyon iken islem sonrasinda gorulen en sik komplikasyon minor kanama olarak saptandi. Sonuc: Trakeostominin, hasta konforunu artirmak, hastalarin solunum cihazindan ayrilmalarini kolaylastirmak, olu boslugu azaltarak pulmoner sekresyonlarin temizlenmesini saglamak gibi avantajlari bulunmaktadir. Perkutan trakeostomi dusuk komplikasyon oranlari nedeniyle daha guvenilir bir islemdir. ABSTRACT Background: To retrospectively evaluate 58 patients who underwent percutaneous tracheostomy in our intensive care unit. Materials and Methods: The study included 58 patients that underwent percutaneous tracheostomy in the ICU at our Anesthesiology and Reanimation department between January 2017 and December 2020. Results: The percutaneous tracheostomy group comprised 33 (56.9%) men and 25 (43.1%) women with a mean age of 65±18.2 (range, 19-90) years. Most common primary diagnosis of hospitalization was neurological disorders (51.7%). Mean APACHE II score was 23.2±3.6, mean time to percutaneous tracheostomy was 18.3±5.1 (range, 7-30) days, mean procedural time was 11.1±2.4 min, mean duration of mechanical ventilation was 62.1±37.8 (range, 15-167) days, mean intensive care unit stay was 67.2±43.5 (range, 15-247) days, and mean hospitalization time was 77.5±50.4 (range, 15-277) days. Hypoxia and hypotension were the most common intraoperative complications and minor bleeding was the most common postoperative complication. Conclusions: Performing early tracheostomy in intensive care unit patients requiring prolonged mechanical ventilation increases patient comfort, facilitates discontinuation of mechanical ventilation, reduces the dead space, facilitates the clearing of airway secretions, and shortens the duration of intensive care unit and hospital stay. Additionally, percutaneous tracheostomy was revealed as a safe procedure for intensive care unit patients due to its lower complication rates.