Bektaş Şerife, Çavuş Mine, Turan Sema
Department of Intensive Care Unit, Ankara State Hospital, Ankara, Turkey.
Department of Intensive Care Unit, Kayseri State Hospital, Kayseri, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jul 28;28(3):435-441. doi: 10.5606/tgkdc.dergisi.2020.19642. eCollection 2020 Jul.
We aimed to investigate the efficacy and safety of percutaneous dilatational tracheostomy procedure following cardiac surgery in patients receiving extracorporeal membrane oxygenation and/or left ventricular assist device.
A total of 42 patients (10 males, 32 females; mean age 51±14.6 years; range, 18 to 77 years) who underwent percutaneous dilatational tracheostomy procedure under extracorporeal membrane oxygenation and/or left ventricular assist device support between January 2017 and January 2019 were retrospectively analyzed. Laboratory data, Simplified Acute Physiology Score-II and Sequential Organ Failure Assessment scores, and major and minor complications were recorded. The 30-day and one-year follow-up outcomes of the patients were reviewed.
Of 42 patients, 17 (42.5%), 14 (33.3%), and 11 (26.2%) received left ventricular assist device, extracorporeal membrane oxygenation, and extracorporeal membrane oxygenation + left ventricular assist device, respectively. During percutaneous dilatational tracheostomy, the laboratory values of the patients were as follows: international normalized ratio, 2.3±0.9; partial thromboplastin time, 59.4±19.5 sec; platelet count, 139.2±65.8×109/L, hemoglobin, 8.8±1.0 g/dL, and creatinine, 1.6±1.0 mg/dL. No peri-procedural mortality, major complication, or bleeding was observed. We observed minor complications including localized stomal ooze in four patients (8.3%) and local stomal infection in three patients (6.2%).
Our study results suggest that percutaneous dilatational tracheostomy is an effective and safe technique in this patient population.
我们旨在研究接受体外膜肺氧合和/或左心室辅助装置的心脏手术后患者经皮扩张气管切开术的有效性和安全性。
回顾性分析2017年1月至2019年1月期间在体外膜肺氧合和/或左心室辅助装置支持下接受经皮扩张气管切开术的42例患者（男性10例，女性32例；平均年龄51±14.6岁；范围18至77岁）。记录实验室数据、简化急性生理学评分-II和序贯器官衰竭评估评分以及主要和次要并发症。回顾患者的30天和1年随访结果。
42例患者中，分别有17例（42.5%）、14例（33.3%）和11例（26.2%）接受了左心室辅助装置、体外膜肺氧合和体外膜肺氧合+左心室辅助装置。在经皮扩张气管切开术中，患者的实验室值如下：国际标准化比值为2.3±0.9；部分凝血活酶时间为59.4±19.5秒；血小板计数为139.2±65.8×10⁹/L，血红蛋白为8.8±1.0 g/dL，肌酐为1.6±1.0 mg/dL。未观察到围手术期死亡、主要并发症或出血。我们观察到的次要并发症包括4例患者（8.3%）出现局部造口渗血和3例患者（6.2%）出现局部造口感染。
我们的研究结果表明，经皮扩张气管切开术在该患者群体中是一种有效且安全的技术。
