Koitschev Assen, Simon Christian, Blumenstock Gunnar, Mach Heike, Graumueller Sylke
Department of Otorhinolaryngology and Head and Neck Surgery, University of Tuebingen, Tuebingen, Germany.
Acta Otolaryngol. 2006 Dec;126(12):1303-8. doi: 10.1080/00016480600702134.
This study provides evidence that the surgical technique used for tracheotomy influences the risk of tracheostomy-related complications. techniques resulting in an epithelialized tracheostoma seem to minimize the risk.
Tracheotomies are frequently performed procedures in critically ill patients requiring long-term ventilation. Hence, we undertook a study to evaluate factors for tracheostomy-related complications among patients with a persisting stoma after critical care.
The patients underwent endoscopic examination of the tracheostoma, larynx, and trachea. The intensive care units (ICUs) were contacted with a questionnaire about the patient's diagnosis, the indication for the tracheotomy, the date of the tracheotomy, and the method of the tracheotomy procedure.
A total of 170 patients were included in this study. In all, 57.6% of the patients had unstable tracheostomas, a stenosis of the tracheal lumen above the stoma was encountered in 48.2% (G I, <50% of the lumen = 27.6% and G II, >50% of the lumen = 20.6%), and below the stoma in 3.5% of the patients. A significant association was found between severe suprastomal stenosis, tracheostoma instability and the use of dilatational tracheotomy (DT) (p<0.001). A malacia of the trachea was significantly more common among female patients (p < 0.010).
