Perkütan Dilatasyon Trakeostomisi için Hava Yolu Yönetiminde Laringeal Maske ve Endotrakeal Entübasyonun Karşılaştırılması

Abstract

Amaç: Trakeostomi işlemi uzamış entübasyon nedeniyle cerrahi yada perkütan teknik kullanılarak yapılan bir işlemdir. Bu işlem sırasında hava yolu güvenliği laringeal maske (LMA) ya da endotrakeal tüp (ETT) ile sağlanmaktadır. Bu çalışmada trakeostomi işlemi esnasında LMA ve ETT kullanımının komplikasyonlarını, işlem süresini ve kan gazı verilerindeki değişimlerini incelmeyi amaçladık. Gereç ve Yöntem: Çalışmaya 2019-2023 yılları arasında Burdur Devlet Hastanesi Yoğun Bakım Kliniklerinde yatan hastalar dahil edilmiştir. Çalışmaya dahil edilen 78 hasta; ETT (n=39) ve LMA (n=39) kullanılanlar olarak iki gruba ayrılmıştır. İşleme ait komplikasyonlar, işlem süreleri, hastaların kan gazı verileri hasta dosyalarından kaydedildi. Bulgular: Gruplar arasında komplikasyonlar açısından istatistiksel fark bulunmadı. LMA ve ETT ile trakeostomi açılan gruplar arasında işlem sonrası PaCO2 değerlerinde istatiksel olarak anlamlı fark yoktu (p<0.439). Trakeostomi öncesi ve sonrası PaO2 değerleri değerlendirildiğinde, hem LMA ve hem de ETT gruplarında düşme olduğu görüldü (her ikisi için de) (p<0,001). Trakeostomi işlemi süreleri karşılaştırıldığında ise LMA grubunda sürenin ETT grubuna göre istatistiksel anlamlı olarak daha kısa olduğu görüldü (p<0,001). Sonuç: Çalışmamızda komplikasyonlar ve kan gazında meydana gelen değişimler açısından LMA ve ETT arasında herhangi istatistiksel olarak bir fark olmadığı görülmüştür. LMA ile trakeostominin ETT ye göre işlem sırasında daha az personel ihtiyacı olması, bronkoskopide görüş netliği ve işlem süresinin daha kısa olması gibi avantajları vardır.

Keywords

• Perkütan dilatasyon trakeostomi
• laringeal maske
• kan gazı
• komplikasyon

Laryngeal Mask Airway Versus Endotracheal Intubation for Airway Management During Percutaneous Dilatational Tracheostomy

Abstract

Aim: Tracheostomy is a common procedure performed surgically or percutaneously due to prolonged intubation. During the procedure, airway safety can be ensured using a laryngeal mask airway (LMA) or an endotracheal tube (ETT). The aim of this study was to investigate the complications associated with the use of LMA and ETT during the tracheostomy procedure, operative time, and changes in blood gas parameters. Materials and Methods: This study included patients admitted to the Intensive Care Units of Burdur State Hospital between 2019 and 2023. A total of 78 patients were divided into two groups: ETT (n=39) and LMA (n=39). Procedure-related complications, operative time, blood gas data were recorded from the patient files. Results: There was no statistically significant difference between the LMA and ETT groups in terms of complications. There was also no statistically significant difference in postoperative values of PaCO2 between the groups (p<0.439). The analysis of pre- and post-tracheostomy PaO2 values indicated a decrease in both the LMA and ETT groups (p<0.001 for both). The comparison of the two groups by the duration of the tracheostomy procedure showed a statistically significant shorter operative time in the LMA group than in the ETT group (p<0.001). Conclusion: Our study demonstrated no statistically significant difference between LMA and ETT in terms of complications and changes in blood gas parameters. Tracheostomy with LMA has advantages over ETT, fewer personnel requirements during the procedure, clear vision in bronchoscopy, and shorter operative time.

Keywords

• Percutaneous dilatational tracheostomy
• laryngeal mask airway
• blood gas
• complication

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