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Yoğun Bakım Ünitesinde Fiberoptik Bronkoskopi Kılavuzluğunda Perkütan Dilatasyonel Trakeostomiye Karşı Klasik Kör Perkütan Dilatasyonel Trakeostomi: Komplikasyonlar, Mortalite ve Sonuçlar

Year 2023, Volume: 25 Issue: 3, 273 - 278, 30.12.2023
https://doi.org/10.18678/dtfd.1350474

Abstract

Amaç: Bu çalışmanın amacı, fiberoptik bronkoskopi (FOB) kılavuzluğu ile klasik kör teknikle gerçekleştirilen perkütan dilatasyonel trakeostomi (PDT) işlemlerinin komplikasyonlar, mortalite ve hasta sonuçları açısından karşılaştırılmasıdır.
Gereç ve Yöntemler: Bu çalışmaya Ekim 2022 ile Haziran 2023 tarihleri arasında yoğun bakım ünitesinde (YBÜ) mekanik ventilatör desteği alan 62 hasta dahil edildi. Hastalar FOB kılavuzluğunda PDT gerçekleştirilenler (grup FOB, n=31) ve klasik kör teknikle PDT gerçekleştirilenler (grup C, n=31) olarak iki gruba randomize edildi. Demografik veriler, klinik özellikler, PDT işlem süreleri, komplikasyonlar ve mortaliteler analiz edildi.
Bulgular: Ortanca yaş 64 (aralık, 19-94) yıl ve hastaların %67,7’si (n=42) erkek idi. Gruplar arasında demografik verilerin benzer olduğu saptandı. PDT işlemi gerçekleştirilen hastalarda en sık primer tanı intrakranyal hemorajiler (%32,3; n=20) idi. Tüm çalışma grubunda medyan trakeostomi açılma zamanı 13 (aralık, 3-31) gün iken gruplar arasında anlamlı bir farklılık yoktu (p=0,637). Ortalama PDT işlem süresi (9,6±3,8’e karşı 12,6±5,4 dakika, p=0,015), ortanca YBÜ kalış süresi (26’ya karşı 37 gün, p=0,004) ve komplikasyon oranı (%6,4’e karşı %25,8; p=0,038) grup FOB’da anlamlı olarak daha düşük saptandı. Tüm çalışma grubunda 28 günlük mortalite %17,7 (n=11) iken gruplar arasında anlamlı bir farklılık yoktu (p=0,740).
Sonuç: FOB kılavuzluğunda gerçekleştirilen PDT işlemlerinde, işlem süresi, YBÜ kalış süresi ve işleme bağlı görülen komplikasyon oranları anlamlı olarak düşük saptanırken, mortalite açısından anlamlı bir farklılık görülmedi.

References

  • Griggs WM, Myburgh JA, Worthley LI. A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy. Intensive Care Med. 1991;17(5):261-3.
  • Durbin CG Jr. Tracheostomy: why, when, and how? Respir Care. 2010;55(8):1056-68.
  • Düger C, İsbir AC, Uysal İÖ, Özdemir Kol İ, Kaygusuz K, Gürsoy S, et al. The evaluation of the complications of surgical and percutaneous tracheostomies in intensive care unit. Turk J Anaesthesiol Reanim. 2013;41(3):84-7. Turkish.
  • Al-Ansari MA, Hijazi MH. Clinical review: percutaneous dilatational tracheostomy. Crit Care. 2006;10(1):202.
  • Yıldırım F, Güllü YT, Demirel CB. Percutaneous tracheostomy in the intensive care unit. Eurasian J Pulmonol. 2015;17(3):136-41.
  • Memmedova F, Ger Akarsu F, Mehdiyev Z, Aykaç Ö, Pınarbaşlı MÖ, Gürbüz MK, et al. Evaluation of percutaneous and surgical tracheostomy results in neurocritical care unit. Turk J Neurol. 2022;28(1):31-7.
  • Arslan K, Sahin AS, Yalcın N, Kaya E. Evaluation of trauma patients followed up and treated in intensive care unit: the sample of Istanbul province training and research hospital. Turk J Intensive Care. 2023;21(1):41-7.
  • Gucyetmez B, Atalan HK, Cakar N; Turkish Tracheotomy Survey Group. Elective tracheotomy practices in Turkey. PLoS One. 2016:11(11):e0166097.
  • Decker S, Gottlieb J, Cruz DL, Müller CW, Wilhelmi M, Krettek C, et al. Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure. Eur J Trauma Emerg Surg. 2016;42(5):605-10.
  • Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB, et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA. 2010;303(15):1483-9.
  • Young D, Harrison DA, Cuthbertson BH, Rowan K; TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA. 2013;309(20):2121-9.
  • Gupta S, Tomar DS, Dixit S, Zirpe K, Choudhry D, Govil D, et al. Dilatational percutaneous vs surgical tracheostomy in intensive care unit: a practice pattern observational multicenter study (DISSECT). Indian J Crit Care Med. 2020;24(7):514-26.
  • Romero CM, Cornejo R, Tobar E, Galvez R, Luengo C, Estuardo N, et al. Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital. Rev Bras Ter Intensiva. 2015;27(2):119-24.
  • Batcik S, Süren M, Cömlekci M, Özdamar M, Özdemir H, Fadıllıoğlu S, et al. Comparison of patients undergoing tracheostomy with and without fiberoptic bronchoscopy. Ann Clin Anal Med. 2021;12(Suppl 3):S333-7.
  • Shen G, Yin H, Cao Y, Zhang M, Wu J, Jiang X, et al. Percutaneous dilatational tracheostomy versus fibreoptic bronchoscopy-guided percutaneous dilatational tracheostomy in critically ill patients: a randomised controlled trial. Ir J Med Sci. 2019;188(2):675-81.
  • Ravi PR, Vijay MN. Real time ultrasound-guided percutaneous tracheostomy: is it a better option than bronchoscopic guided percutaneous tracheostomy? Med J Armed Forces India. 2015;71(2):158-64.
  • Karvandian K, Mahmoodpoor A, Beigmohammadi M, Sanaie S. Complications and safety of percutaneous dilatational tracheostomy with Griggs method versus surgical tracheostomy: A prospective trial with six months follow-up. Pak J Med Sci. 2009;25(1):41-5.
  • Saritas A, Saritas PU, Kurnaz MM, Beyaz SG, Ergonenc T. The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice. J Pak Med Assoc. 2016;66(1):83-9.
  • Dennis BM, Eckert MJ, Gunter OL, Morris JA Jr, May AK. Safety of bedside percutaneous tracheostomy in the critically ill: Evaluation of more than 3,000 procedures. J Am Coll Surg. 2013;216(4):858-65.
  • Cabrini L, Monti G, Landoni G, Biondi-Zoccai G, Boroli F, Mamo D, et al. Percutaneous tracheostomy, a systematic review. Acta Anaesthesiol Scand. 2012;56(3):270-81.
  • Eminoğlu S, Özgünay ŞE. Comparison of percutaneous dilatational tracheostomy via fiberoptic bronchoscopy with standard percutaneous dilatational tracheostomy: a prospective randomized trial. Med Bull Haseki. 2020;58(1):78-83. Turkish.
  • Karaca Ü, Onur T, Eminoğlu S, Özgünay SE, Ata F. The comparison of ultrasonography-guided percutaneous tracheostomy with fiberoptic bronchoscopy-guided percutaneous tracheostomy: clinical experimental research. Turkiye Klinikleri J Anest Reanim. 2022;20(1):16-22. Turkish.

Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes

Year 2023, Volume: 25 Issue: 3, 273 - 278, 30.12.2023
https://doi.org/10.18678/dtfd.1350474

Abstract

Aim: This study aimed to compare percutaneous dilatational tracheostomy (PDT) procedures performed with fiberoptic bronchoscopy (FOB) guidance and classical blind technique regarding complications, mortality, and patient outcomes.
Material and Methods: This study included 62 patients receiving mechanical ventilator support in the intensive care unit (ICU) between October 2022 and June 2023. Patients were randomized into two groups: those who underwent FOB-guided PDT (group FOB, n=31) and those who underwent PDT with the classical blind technique (group C, n=31). Demographic data, clinical characteristics, PDT procedure times, complications, and mortalities were analyzed.
Results: The median age was 64 (range, 19-94) years, and 67.7% (n=42) of the patients were male. Demographic data were found similar between groups. The most common primary diagnosis in patients who underwent PDT was intracranial hemorrhages (32.3%, n=20). While the median tracheostomy opening time in the entire study group was 13 (range, 3-31) days, there was no significant difference between the groups (p=0.637). The mean PDT procedure time (9.6±3.8 vs 12.6±5.4 min, p=0.015), median ICU stay (26 vs 37 days, p=0.004), and complication rate (6.4% vs 25.8%, p=0.038) were found to be significantly lower in group FOB. While the 28-day mortality in the entire study group was 17.7% (n=11), there was no significant difference between the groups (p=0.740).
Conclusion: In PDT procedures performed under FOB guidance, procedure time, length of stay in the ICU, and procedure-related complication rates were significantly lower, while no significant difference was observed in terms of mortality.

References

  • Griggs WM, Myburgh JA, Worthley LI. A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy. Intensive Care Med. 1991;17(5):261-3.
  • Durbin CG Jr. Tracheostomy: why, when, and how? Respir Care. 2010;55(8):1056-68.
  • Düger C, İsbir AC, Uysal İÖ, Özdemir Kol İ, Kaygusuz K, Gürsoy S, et al. The evaluation of the complications of surgical and percutaneous tracheostomies in intensive care unit. Turk J Anaesthesiol Reanim. 2013;41(3):84-7. Turkish.
  • Al-Ansari MA, Hijazi MH. Clinical review: percutaneous dilatational tracheostomy. Crit Care. 2006;10(1):202.
  • Yıldırım F, Güllü YT, Demirel CB. Percutaneous tracheostomy in the intensive care unit. Eurasian J Pulmonol. 2015;17(3):136-41.
  • Memmedova F, Ger Akarsu F, Mehdiyev Z, Aykaç Ö, Pınarbaşlı MÖ, Gürbüz MK, et al. Evaluation of percutaneous and surgical tracheostomy results in neurocritical care unit. Turk J Neurol. 2022;28(1):31-7.
  • Arslan K, Sahin AS, Yalcın N, Kaya E. Evaluation of trauma patients followed up and treated in intensive care unit: the sample of Istanbul province training and research hospital. Turk J Intensive Care. 2023;21(1):41-7.
  • Gucyetmez B, Atalan HK, Cakar N; Turkish Tracheotomy Survey Group. Elective tracheotomy practices in Turkey. PLoS One. 2016:11(11):e0166097.
  • Decker S, Gottlieb J, Cruz DL, Müller CW, Wilhelmi M, Krettek C, et al. Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure. Eur J Trauma Emerg Surg. 2016;42(5):605-10.
  • Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB, et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA. 2010;303(15):1483-9.
  • Young D, Harrison DA, Cuthbertson BH, Rowan K; TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA. 2013;309(20):2121-9.
  • Gupta S, Tomar DS, Dixit S, Zirpe K, Choudhry D, Govil D, et al. Dilatational percutaneous vs surgical tracheostomy in intensive care unit: a practice pattern observational multicenter study (DISSECT). Indian J Crit Care Med. 2020;24(7):514-26.
  • Romero CM, Cornejo R, Tobar E, Galvez R, Luengo C, Estuardo N, et al. Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital. Rev Bras Ter Intensiva. 2015;27(2):119-24.
  • Batcik S, Süren M, Cömlekci M, Özdamar M, Özdemir H, Fadıllıoğlu S, et al. Comparison of patients undergoing tracheostomy with and without fiberoptic bronchoscopy. Ann Clin Anal Med. 2021;12(Suppl 3):S333-7.
  • Shen G, Yin H, Cao Y, Zhang M, Wu J, Jiang X, et al. Percutaneous dilatational tracheostomy versus fibreoptic bronchoscopy-guided percutaneous dilatational tracheostomy in critically ill patients: a randomised controlled trial. Ir J Med Sci. 2019;188(2):675-81.
  • Ravi PR, Vijay MN. Real time ultrasound-guided percutaneous tracheostomy: is it a better option than bronchoscopic guided percutaneous tracheostomy? Med J Armed Forces India. 2015;71(2):158-64.
  • Karvandian K, Mahmoodpoor A, Beigmohammadi M, Sanaie S. Complications and safety of percutaneous dilatational tracheostomy with Griggs method versus surgical tracheostomy: A prospective trial with six months follow-up. Pak J Med Sci. 2009;25(1):41-5.
  • Saritas A, Saritas PU, Kurnaz MM, Beyaz SG, Ergonenc T. The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice. J Pak Med Assoc. 2016;66(1):83-9.
  • Dennis BM, Eckert MJ, Gunter OL, Morris JA Jr, May AK. Safety of bedside percutaneous tracheostomy in the critically ill: Evaluation of more than 3,000 procedures. J Am Coll Surg. 2013;216(4):858-65.
  • Cabrini L, Monti G, Landoni G, Biondi-Zoccai G, Boroli F, Mamo D, et al. Percutaneous tracheostomy, a systematic review. Acta Anaesthesiol Scand. 2012;56(3):270-81.
  • Eminoğlu S, Özgünay ŞE. Comparison of percutaneous dilatational tracheostomy via fiberoptic bronchoscopy with standard percutaneous dilatational tracheostomy: a prospective randomized trial. Med Bull Haseki. 2020;58(1):78-83. Turkish.
  • Karaca Ü, Onur T, Eminoğlu S, Özgünay SE, Ata F. The comparison of ultrasonography-guided percutaneous tracheostomy with fiberoptic bronchoscopy-guided percutaneous tracheostomy: clinical experimental research. Turkiye Klinikleri J Anest Reanim. 2022;20(1):16-22. Turkish.
There are 22 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Research Article
Authors

Kadir Arslan 0000-0003-4061-0746

Ebru Kaya 0000-0002-9506-0756

Ayça Sultan Şahin 0000-0002-7765-5297

Early Pub Date November 30, 2023
Publication Date December 30, 2023
Submission Date August 29, 2023
Published in Issue Year 2023 Volume: 25 Issue: 3

Cite

APA Arslan, K., Kaya, E., & Şahin, A. S. (2023). Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Duzce Medical Journal, 25(3), 273-278. https://doi.org/10.18678/dtfd.1350474
AMA Arslan K, Kaya E, Şahin AS. Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Duzce Med J. December 2023;25(3):273-278. doi:10.18678/dtfd.1350474
Chicago Arslan, Kadir, Ebru Kaya, and Ayça Sultan Şahin. “Classical Blind Percutaneous Dilatational Tracheostomy Vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes”. Duzce Medical Journal 25, no. 3 (December 2023): 273-78. https://doi.org/10.18678/dtfd.1350474.
EndNote Arslan K, Kaya E, Şahin AS (December 1, 2023) Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Duzce Medical Journal 25 3 273–278.
IEEE K. Arslan, E. Kaya, and A. S. Şahin, “Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes”, Duzce Med J, vol. 25, no. 3, pp. 273–278, 2023, doi: 10.18678/dtfd.1350474.
ISNAD Arslan, Kadir et al. “Classical Blind Percutaneous Dilatational Tracheostomy Vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes”. Duzce Medical Journal 25/3 (December 2023), 273-278. https://doi.org/10.18678/dtfd.1350474.
JAMA Arslan K, Kaya E, Şahin AS. Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Duzce Med J. 2023;25:273–278.
MLA Arslan, Kadir et al. “Classical Blind Percutaneous Dilatational Tracheostomy Vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes”. Duzce Medical Journal, vol. 25, no. 3, 2023, pp. 273-8, doi:10.18678/dtfd.1350474.
Vancouver Arslan K, Kaya E, Şahin AS. Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Duzce Med J. 2023;25(3):273-8.