Fikkers Bernard G, Fransen Gerdine A J, van der Hoeven Johannes G, Briedé Inge S, van den Hoogen Frank J A
Department of Intensive Care, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Intensive Care Med. 2003 Aug;29(8):1390-3. doi: 10.1007/s00134-003-1824-x. Epub 2003 Jul 22.
To assess the frequency, timing, technique, and follow-up of tracheostomy for long-term ventilated patients in different intensive care units (ICUs) in The Netherlands.
Postal questionnaire, survey on retrospective data. A questionnaire was sent to all ( n=63) ICUs with six or more beds suitable for mechanical ventilation and officially recognized by The Netherlands Intensive Care Society. Pediatric ICUs were excluded.
There was an 87% ( n=55) response rate of contacted ICUs. The number of tracheostomies per year per unit varied widely (range 1-75), most ICUs (42%) performing between 11 and 25 tracheostomies per year. In 44% of ICUs ( n=24) tracheostomy was not performed on a routine basis. In 25% of ICUs ( n=14) tracheostomies were performed during the second week of ventilation. Surgical tracheostomy and percutaneous procedures were technique of first choice in 38% and 62% of ICUs, respectively. In only 7% of units were late follow-up protocols in use. Thirty-two units (58%) reported a total of 56 major complications.
Timing and technique of tracheostomy varies widely in Dutch ICUs. The percutaneous technique is the procedure of choice for tracheostomy in most of these units. Late follow-up protocols are rarely in use.
评估荷兰不同重症监护病房（ICU）中长期机械通气患者气管切开术的频率、时机、技术及随访情况。
邮寄问卷调查，回顾性数据调查。向荷兰重症监护学会认可的所有63家适合机械通气且床位不少于6张的ICU发放问卷，儿科ICU除外。
被调查的ICU的回复率为87%（n = 55）。各单位每年气管切开术的数量差异很大（范围为1 - 75例），大多数ICU（42%）每年进行11至25例气管切开术。44%的ICU（n = 24）未常规进行气管切开术。25%的ICU（n = 14）在通气的第二周进行气管切开术。手术气管切开术和经皮气管切开术分别是38%和62%的ICU的首选技术。仅7%的单位采用后期随访方案。32个单位（58%）共报告了56例主要并发症。
荷兰ICU中气管切开术的时机和技术差异很大。经皮技术是这些单位中大多数气管切开术的首选方法。很少采用后期随访方案。
