Experience Of Our Percutaneous Dılatatıonal Tracheostomy By Usıng Grıggs Technıque At Antakya State Hospıtal; 168 Cases

Abstract

Aim: During the last two decades the use of
percutaneous dilatational tracheostomy (PDT)
in critically ill patients has been increased
instead of the standard open surgery technique.
In this study we aimed to present our PDT
practices by using Grigg’s tecnique.
Material and Method: The data of 168
patients who were performed PDT by using
Griggs technique at Antakya State Hospital
between january 2010 and december 2012,
were analyzed retrospectively. Demographic
datas of patients, APACHE II scores,
entubation time, vital parameters, mechanic
ventilation time, the pocedure time, diagnosis
of patients were recorded. Minor bleeding,
major bleeding, subcutaneous emphysema,
pneumothorax, desaturation, arrhythmia and
damage of the trachea were recorded as early
complications of the procedure.
Results: Gunshot injuries are the most
common admissional diagnosis in 71 (42%)
patients. The rate of early complication was
15.4% and minor bleeding was the common
with 16 (9.5%) patients. 2 patients (%1.2) had
major bleeding. Mean procedure time was 8.9
min. and mean entubation time was 6.7 days. 5
patients (2.9%) had desaturation and improved
in early period. Subcutaneous emphysema
ocurred in one patient (0.6%).
Conclusion: PDT is a simple, quick, and safe
procedure at the bedside in intensive care unit
and has low serious complication rates. 

Keywords

• Intensive Care
• Percutaneous Dilatational Tracheostomy
• Griggs technique

ANTAKYA DEVLET HASTANESİNDE GRİGGS TEKNİĞİ İLE PERKÜTAN DİLATASYONEL TRAKEOSTOMİ DENEYİMLERİMİZ; 168 OLGU

Abstract

Amaç: Son 20 yılda yoğun bakım hastalarında
perkütan dilatasyonal trakeostomi (PDT)
uygulaması standart açık cerrahi tekniğe oranla
artmıştır. Biz bu çalışmada Griggs tekniği ile
yapılan PDT uygulamalarımızı sunmayı
amaçladık.
Gereç ve Yöntem: Ocak 2010 ile aralık 2012
arasında Antakya devlet hastanesinde PDT
uygulanan 168 hasta retrospektif olarak
değerlendirildi. Hastaların demografik verileri,
Akut ve Kronik Fizyolojik Sağlık
Değerlendirme skorları (APACHE II), vital
parametreleri, mekanik ventilasyon (MV)
süreleri, entübasyon süreleri, işlem süreleri ve
yatış tanıları kaydedildi. Erken dönem
komplikasyonlar olarak minör kanama, major
kanama, subkutan amfizem, pnömotoraks,
desaturasyon, aritmi ve trakeal hasar ele alındı.
Bulgular: Yatış tanısı olarak en fazla oranda
71 hastada(%42) ateşli silah yaralanmaları
olduğu görüldü. Erken dönem komplikasyon
oranı % 15.4 iken minör kanamalar 16 hasta ile
(%9.5) en sık olarak bulundu. 2 hastada (%1.2)
major kanama tespit edildi. Ortalama girişim
süresi 8.9 dk, entübasyon süresi 6.7 olarak
bulundu. 5 hastada (%2.9) desaturasyon
görüldü ve erken dönemde düzeldi. 1 hastada
(%0.6) ise ciltaltı amfizem gelişti.

Sonuç: Yoğun bakımda yatak başı uygulanan
PDT işlemi basit, hızlı ve güvenlidir ve çok az
ciddi komplikasyon oranına sahiptir.

Keywords

• yoğun bakım
• perkütan dilatasyonal trakeostomi
• griggs tekniği

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