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

Year 2012, Volume: 3 Issue: 11, 7 - 12, 03.03.2015

Mustafa Özgür , Celalettin Dağlı Fatma Ceylan Harun Atıcı Murat Karcıoğlu

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

References

• 1. Griggs WM, Worthley LIG, Gilligan JE, Thomas PD, Myberg JA. A simple percutaneous tracheostomy tecnique. Surg Gynecol Obstet. 1990;170:543-5.
• 2. Griggs WM, Myburgh JA, Worthley LIG. A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy. Intensive Care Med. 1991;17:261-3.
• 3. Angel LF, Simpson CB. Comparison of surgical and percutaneous dilatational tracheostomy. Clin Chest Med. 2003;24:423-9.
• 4. Crofts SL, Alzeer A, McGuire GP, et al. A comparison of percutaneous and operative tracheostomies in intensive care patients. Can J Anaesth. 1995;42:775-79.
• 5. Hutchinson RC, Mitchell RD. Life-threatening complications from percutaneous dilatational tracheostomy. Crit Care Med. 1991;19:118-20.
• 6. Griffiths J, BarberVS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ. 2005;330:1243.
• 7. Disayabutr S, Tscheikuna J, Tangsujaritvijit V, Nana A. Experience of percutaneous dilatational tracheostomy by using Grigg’s technique in Siriraj Hospital. J Med Assoc Thai. 2013;96:22-8.
• 8. Pietkiewicz P, Machala W, Kusmierczyk K, Milonski J, Wisniewski T, Urbaniak J et al. Early complications of Griggs percutaneous tracheotomy in the own material. Otolaryngol Pol. 2012;66(3):196-200.
• 9. Van Heurn LW,Van Geffen GJ, Brink PR. Clinical experience with percutaneous dilatational tracheostomy: report of 150 cases. Eur J Surg. 1996;162:531-5.
• 10. Kearney PA, Griffen MM, Ochoa JB, Boulanger BR, Tseui BJ, Mentzer RM. A snglecenter 8-year experience with percutaneous dilatational tracheostomy. Ann Surg. 2000;231;701-9.
• 11. Çiçek M, Gedik E, Yücel A, Köroğlu A, Ersoy MÖ. Griggs tekniği ile açılan perkütan trakeostomi sonuçlarımız. İnönü Üniversitesi Tıp Fak. Dergisi. 2007;14(1):17-20.
• 12. Friedman Y, Fildes J, Benitone J. Comparison of percutaneous and surgical tracheostomies. Chest. 1996;110:480-5.
• 13. Hazard P, Jones C, Benitone J. Comperative clinical trial of Standard operative tracheostomy with percutaneous tracheostomy. Crit Care Med. 1991;19:1018-24.