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800例综合重症监护病房患者经皮气管切开术的安全性及并发症

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients.

作者信息

Díaz-Regañón G, Miñambres E, Ruiz A, González-Herrera S, Holanda-Peña M, López-Espadas F

机构信息

Service of Intensive Care Medicine, Hospital Universitario Marqués de Valdecilla, Avenida Marqués de Valdecilla s/n, E-39008 Santander, Spain.

出版信息

Anaesthesia. 2008 Nov;63(11):1198-203. doi: 10.1111/j.1365-2044.2008.05606.x. Epub 2008 Aug 19.

Abstract

Percutaneous tracheostomy is used primarily to assist weaning from mechanical ventilation in the intensive care unit. We report our experiences of 800 such procedures performed in the intensive care unit by a collaborative team (critical care and ENT specialists). Most procedures (85.6%) were performed by residents supervised by the intensive care unit staff. Complications occurred in 32 patients (4%). Intraprocedural complications occurred in 17 patients (2.1%), early postprocedural complications in six (0.75%), and late postprocedural complications in nine (1.1%). No deaths were directly related to percutaneous tracheostomy. The incidence of complications was greater in percutaneous tracheostomy performed by the residents during their initial five attempts compared to their later attempts (9.2% vs 2.6%, p < 0.05). The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure in daily care of intensive care unit patients.

摘要

经皮气管切开术主要用于重症监护病房协助患者脱离机械通气。我们报告了一个协作团队(重症监护和耳鼻喉科专家)在重症监护病房进行的800例此类手术的经验。大多数手术(85.6%)由在重症监护病房工作人员监督下的住院医师完成。32例患者(4%)出现并发症。术中并发症发生在17例患者(2.1%),术后早期并发症发生在6例(0.75%),术后晚期并发症发生在9例(1.1%)。无死亡与经皮气管切开术直接相关。与后来的尝试相比,住院医师最初五次尝试进行经皮气管切开术时并发症发生率更高(9.2%对2.6%,p<0.05)。并发症的低发生率表明,床边经皮气管切开术可作为重症监护病房患者日常护理的常规程序安全进行。

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