Carnero Echegaray Joaquín, Larocca Florencia, Bellon Pablo, Bosso Mauro
Santa Catalina Neurorehabilitación Clínica.
Rev Fac Cien Med Univ Nac Cordoba. 2024 Sep 27;81(3):477-490. doi: 10.31053/1853.0605.v81.n3.43477.
Tracheostomy (TQT) has emerged as a valuable alternative for patients with orotracheal intubation, especially those under prolonged mechanical ventilation (VMP), as in the case of chronic obstructive pulmonary disease (COPD). This population presents additional challenges, and the available information regarding their progression in specialized centers is limited in Argentina.A descriptive, retrospective, and cross-sectional study was conducted at Santa Catalina Neurorehabilitation Clinic between August 2015 and December 2018. Patients with COPD referred to the Intensive Care Unit (ICU), tracheostomized, and subsequently referred to the Center for Ventilation Disconnection and Rehabilitation (CDVMR) were included. Cases with missing data or derived from other CDVMRs were excluded. Clinical records and interviews were employed to collect demographic and progression data.Out of the 27 COPD patients included (4.9% of 555), the majority were males (63%) with an average age of 68.1 years. Most were admitted with AVMi, and 11 (45.8%) were successfully disconnected, while 11 (40.7%) were decannulated. Survival and home discharge were more frequent in decannulated patients (81.8% were discharged) compared to non-decannulated ones (50% deceased, and none were discharged).COPD patients undergoing TQT and VMP, who succeed in being decannulated, seem to have better prospects for survival and home discharge compared to those who do not have the cannula removed. There is a suggestion for the need for additional analytical studies to confirm these findings and improve the understanding of this specific population.
气管造口术(TQT)已成为口气管插管患者的一种有价值的替代方法,特别是对于那些需要长期机械通气(VMP)的患者,如慢性阻塞性肺疾病(COPD)患者。这一人群面临着额外的挑战,而在阿根廷,关于他们在专业中心的病情进展的可用信息有限。
2015年8月至2018年12月期间,在圣卡塔利娜神经康复诊所进行了一项描述性、回顾性和横断面研究。纳入了被转诊至重症监护病房(ICU)、接受气管造口术并随后被转诊至通气脱机与康复中心(CDVMR)的COPD患者。排除数据缺失或来自其他CDVMR的病例。采用临床记录和访谈来收集人口统计学和病情进展数据。
在纳入的27例COPD患者中(占555例的4.9%),大多数为男性(63%),平均年龄为68.1岁。大多数患者因急性呼吸衰竭入院,11例(45.8%)成功脱机,11例(40.7%)拔管。与未拔管的患者相比,拔管患者的生存率和出院回家的情况更为常见(81.8%出院),而未拔管患者中有50%死亡,无一例出院。
与未拔管的COPD患者相比,接受TQT和VMP且成功拔管的患者似乎有更好的生存和出院回家的前景。建议需要进行更多的分析研究来证实这些发现,并增进对这一特定人群的了解。