Joshi S, Agrawal B, Deo G P, Bhattarai B K, Rahman T R, Biswas B K
Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Kathmandu Univ Med J (KUMJ). 2006 Jul-Sep;4(3):275-80.
Percutaneous dilational tracheostomy (PDT) is frequently performed in the intensive care unit to prevent the long term complications associated with prolonged endotracheal intubation.
To report the analysis of our experience with percutaneous dilation tracheostomy.
A prospective documentation of 40 patients who received percutaneous dilational tracheostomy in a multidisciplinary intensive care unit during a 12-month period.
The patients demographic, indications of intubation and PDT, time required to perform the procedure, complications and the outcome of these patients in the intensive care unit were noted.
Among 425 patients, 40 underwent percutaneous dilational tracheostomy that included 22 females and 18 males with the median age of 35 years. Prolonged ventilatory support was the most common indication for tracheostomy. The average duration of intubation before PDT was 5 days. Median procedure time was 20 minutes. Complications included minor bleeding in two (5%), subcutaneous emphysema with pneumothorax in two patients (5%), tracheal stenosis in three (7.5%), tracheo-esophageal fistula and glottic granuloma in one patient each (2.5%). Among forty patients, 28 (70%) were discharged to the ward, 8 died in intensive care unit and 4 left hospital against medical advice.
Percutaneous dilational tracheostomy is a safe, quick and effective way for long term airway management in critically ill patients.
经皮扩张气管切开术(PDT)常在重症监护病房进行,以预防与长期气管插管相关的远期并发症。
报告我们经皮扩张气管切开术的经验分析。
对12个月期间在多学科重症监护病房接受经皮扩张气管切开术的40例患者进行前瞻性记录。
记录患者的人口统计学资料、插管及PDT的指征、手术所需时间、并发症以及这些患者在重症监护病房的结局。
在425例患者中,40例接受了经皮扩张气管切开术,其中女性22例,男性18例,中位年龄35岁。延长通气支持是气管切开术最常见的指征。PDT前的平均插管时间为5天。中位手术时间为20分钟。并发症包括2例(5%)少量出血、2例患者(5%)出现皮下气肿合并气胸、3例(7.5%)气管狭窄、1例患者(2.5%)出现气管食管瘘和1例患者(2.5%)出现声门肉芽肿。40例患者中,28例(70%)出院至病房,8例在重症监护病房死亡,4例自动出院。
经皮扩张气管切开术是危重症患者长期气道管理的一种安全、快速且有效的方法。