THE COMPARISON OF PERCUTANEOUS AND SURGICAL TRACHEOSTOMY IN NEUROSURGERY INTENSIVE CARE UNIT: A CLINICAL RESEARCH

Year 2013, Volume: 4 Issue: 15, 7 - 11, 03.03.2015

S. Başarslan Cüneyt Göçmez Kağan Kamaşak

Abstract

Aim: Tracheostomy is one of the most common procedures performed in trauma patients in the intensive care unit for ceasing from mechanical ventilation. Open tracheostomy involves dissection of the pretracheal tissues, and insertion of the tracheostomy cannula into the trachea under direct vision. Percutaneous dilatational tracheostomy is increasingly popular and has gained widespread popularity in many intensive care unit and trauma centers. Aim of the study was to compare percutaneous dilatational tracheostomy with conventional open tracheostomy in many ways at neurosurgery intensive care. Patients and Methods: 49 critically ill patients admitted to intensive care unit subjected to tracheostomy and randomly divided into two groups; conventional open tracheostomy. Three separate neurosurgeon who was in charge at neurosurgical intensive care unit performed the process as in bedside

Keywords

neurosurgTracheostomy, intensive care, percutaneous, neurosurg

THE COMPARISON OF PERCUTANEOUS AND SURGICAL TRACHEOSTOMY IN NEUROSURGERY INTENSIVE CARE UNIT: A CLINICAL RESEARCH

Abstract

Aim: Tracheostomy is one of the most common procedures performed in trauma patients in the intensive care unit for ceasing from mechanical ventilation. Open tracheostomy involves dissection of the pretracheal tissues, and insertion of the tracheostomy cannula into the trachea under direct vision. Percutaneous dilatational tracheostomy is increasingly popular and has gained widespread popularity in many intensive care unit and trauma centers. Aim of the study was to compare percutaneous dilatational tracheostomy with conventional open tracheostomy in many ways at neurosurgery intensive care. Patients and Methods: 49 critically ill patients admitted to intensive care unit subjected to tracheostomy and randomly divided into two groups; percutaneous tracheostomy and conventional open tracheostomy. Three separate neurosurgeon who was in charge at neurosurgical intensive care unit performed the process as in bedside. 

Results: According to process times, the percutaneous tracheostomy was found to take significantly shorter duration compared to standard tracheostomy (p=0,0001). Also, the rate of subcutaneous emphysema and intra-operative bleeding is statistically lower at percutaneous tracheostomy group (p0.05). Moreover, postop complications such as wound infection, Tube dislodgement, delayed closure, Tracheal stenosis and unesthetic scar was detected in the lower figure, but it was not meaningful at all. After operation; bleeding, pneumothorax, vocal cord paralysis for both groups were nearly similar without any statistically difference.

Conclusion: Percutaneous technique is effective and safe with low incidence of per and postoperative complication. The risk of complication is significantly lowered after percutaneous than open tracheostomy.

Keywords

Tracheostomy, intensive care, percutaneous, neurosurg

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