重症监护病房患者的经皮扩张气管切开术

Percutaneous dilation tracheotomy in intensive care unit patients.

作者信息

Bhatti Nasir, Tatlipinar Arzu, Mirski Marek, Koch Wayne M, Goldenberg David

机构信息

Department of Ototolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Otolaryngol Head Neck Surg. 2007 Jun;136(6):938-41. doi: 10.1016/j.otohns.2006.12.001.

DOI:10.1016/j.otohns.2006.12.001

PMID:17547983

Abstract

OBJECTIVES

In our department, we routinely use percutaneous dilation tracheotomy (PDT) in select intensive care unit (ICU) patients requiring prolonged intubation and mechanical ventilation. We present our experience with this technique and discuss the pros and cons of PDT in the intensive care setting.

STUDY DESIGN AND SETTING

We conducted a retrospective study of consecutive PDTs performed in our institution between 2002 and 2004. Demographic information and procedural and postoperative complications were noted.

RESULTS

Two hundred seventy-four PDTs were performed on intensive care unit patients during this time period. Complications included five cases of excessive intraoperative bleeding (1.8%), one postoperative hemorrhage (0.3%), one tracheoesophageal fistula (0.3%), one pneumothorax (0.3%), and four accidental decannulations (1.4%). No PDT-associated deaths occurred.

CONCLUSIONS

PDT is advantageous for the patient as it is performed at bedside in the ICU. It is our conclusion that this technique is suitable for many, but not all, critical care patients.

摘要