Retrospective Analysis of Our Experience with Percutaneous Tracheostomy in Our Intensive Care Unit

Abstract

Aim: Percutaneous tracheostomy (PT) application has advantages such as being able to be applied at the bedside in a short time and less bleeding. It is frequently preferred in intensive care units with indications such as prolonged artificial respiration requirement, facilitating weaning, and providing emergency airway. It is an alternative method to surgical tracheostomy. In this study, we aimed to retrospectively evaluate the percutaneous tracheostomy cases we performed in the Intensive Care Unit (ICU) in the last three years. Material and Methods: Patients who underwent percutaneous tracheostomy in the 3rd Level our Hospital between January 2018 and December 2022 were examined. Demographic data of the patients, diagnosis of hospitalization, Acute Physiology and Chronic Health Evaluation II Score (APACHE II score), hospitalization time, intubation time, time from intubation to tracheostomy, early and late complications of tracheostomy were retrospectively analyzed. Results: Ninety-seven patients were analyzed. The mean age of the patients was 77.6±10.9 (range, 41-100) years and the female-male ratio was 40/57. The most common hospitalization diagnosis was neurological reasons (54.6%). The patients were intubated for 20.3±7.9 (range, 7-48) days and the total length of stay in the ICU 65.3±30.3 (range, 17-175) days. The number of patients who developed complications related to the PT procedure was 17 (12.9%). Conclusion: Percutaneous tracheotomy, which is performed in the ICU with indications such as the need for prolonged mechanical ventilation, facilitating weaning, and providing an emergency airway, is a simple, minimally invasive procedure with a low complication rate.

Keywords

• complication
• tracheostomy
• Intensive care unit

Kaynakça

1. 1. Esteller-Moré E, Ibañez J, Matino E, et al. Prognostic factors in laryngotracheal injury following intubation and/or tracheotomy in ICU patients. Eur Arch Otorhinolaryngol. 2005;262:880-3.
2. 2. Duger C, Isbir AC, Uysal IO, et al. The evaluation of the complications of surgical and percutaneous tracheostomies in intensive care unit. Turk J Anaesthesiol Reanim. 2013;41:84-7.
3. 3. Pappas S, Maragoudakis P, Vlastarakos P, et al. Surgical versus percutaneous tracheostomy: an evidence-based approach. Eur Arch Otorhinolaryngol. 2011;268:323-30.
4. 4. Mota LA, de Cavalho GB, Brito VA. Laryngeal complications by orotracheal intubation: literature review. Int Arch Otorhinolaryngol. 2012;16:236-45.
5. 5. Atlas A, Altay N. Our percutaneous tracheostomy experience in our intensive care unit: a retrospective analysis. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18:104-8.
6. 6. Freeman BD, Isabella KL, Buchman TG. A meta analysis of prospective trials comparing percutaneous and surgical tracheostomy in critically ill patients. Chest. 2000;118:1412-8.
7. 7. Antonelli M, Michetti V, Di Palma A, et al. Percutaneous translaryngeal versus surgical tracheostomy: a randomized trial with 1-yr double-blind follow-up. Crit Care Med. 2005;33:1015-20.
8. 8. Anon JM, Gomez V, Escuela P, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care 2000;4:124-8.

9. 9. Rao BK, Pande R, Sharma SC, et al. Percutaneous tracheostomy. Annals of Cardiac Anaesthesia. 2003;6:19-26.
10. 10. De Leyn P, Bedert L, Delcroix M. , et al; Belgian Association of Pneumology and Belgian Association of Cardiothoracic Surgery. Tracheotomy: clinical review and guidelines. Eur J Cardiothorac Surg. 2007;32:412-21.
11. 11. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A simple bedside procedure; preliminary report. Chest. 1985;87:715-9.
12. 12. Totoz T, Türk HŞ, Sayın P, Ünsal O, Çınar S, Oba S. Yoğun bakım ünitemizdeki (YBÜ) perkütan trakeotomi pratiğimiz. Ş.E.E.A.H. Tıp Bülteni. 2013;47:11-5.
13. 13. Çanakçı E, Şahin AE, Kılıç K. Percutaneous tracheostomy with Grigss dilating forceps technique: Retrospective analysis of 60 intensive care patients. Ege Journal of Medicine. 2016;55:184-9.
14. 14. François B, Clavel M, Desachy A, et al. Complications of tracheostomy performed in the ICU: subthyroid tracheostomy vs surgical cricothyroidotomy. Chest. 2003;123:151-8.
15. 15. Eminoğlu Ş, Özgünay ŞE, Comparison of percutaneous dilatational tracheostomy via fiberoptic bronchoscopy with standard percutaneous dilatational tracheostomy: a prospective randomized trial. Med Bull Haseki. 2020;58:78-83.
16. 16. Öncül S, Yılmaz M, Gaygusuz EA, et al. Our experience in percutaneous tracheostomy which performed by Griggs method: 38 cases. Kocaeli Med J. 2014;3:1-4.
17. 17. Ersoy A, Ali A, Ünlü N, et al. 53 percutaneous tracheostomy cases performed with griggs method. Okmeydanı Tıp Dergisi. 2012;28:134-7.
18. 18. Destegül D, Kocaöz FŞ, Özkan Kuşcu Ö. Percutaneous and surgical tracheostomy experience in intensive care. Kırıkkale Üni Tıp Derg. 2020;22:192-8.
19. 19. Koc A. Percutaneous dilatational tracheostomy with bronchoscopic guidance in intensive care unit. JARSS. 2022;30:245-9.
20. 20. Khammas AH, Dawood MR. Timing of tracheostomy in intensive care unit patients. Int Arch Otorhinolaryngol. 2018;22:437-42.
21. 21. Yıldırım F, Güllü YT, Demirel CB. Percutaneous tracheostomy in the ıntensive care unit. Eurasian J Pulmonol. 2015;17:136-41.
22. 22. Karasu D, Yılmaz C, Baytar Ç, Korfalı G. Retrospective analysis of percutaneous tracheostomi cases in intensive care unit. Turk J Intensive Care. 2018;16:83-7.
23. 23. Kearney PA, Griffen MM, Ochoa JB, et al. A single-center 8-year experience with percutaneous dilatational tracheostomy. Ann Surg. 2000;231:701-9.
24. 24. Akıncı SB, Kanbak M, Aypar Ü. Perkütan trakeostomi. Yoğun Bakım Dergisi. 2003;3:149-59.
25. 25. Shlugman D, Satya-Krishna R, Loh L. Acute fatal haemorrhage during percutaneous dilatational tracheostomy. Br J Anaesth. 2003;90:517-20.
26. 26. Ayoub OM, Griffiths MV. Aortic arch laceration: a lethal complication after percutaneous tracheostomy. Laryngoscope. 2007;117:176-8.
27. 27. Muhammad JK, Major E, Wood A, Patton W. Percutaneous dilatational tracheostomy: Hemorrhagic complications and the vascular anatomy of the anterior neck. A review based on 497 cases. Int J Oral Maxillofac Surg. 2000;29:217-22.
28. 28. Richard SI, James MR. Interventions in intensive care and techniques. 3th edition, Nobel Tıp Kitabevi, 2005;150-9.
29. 29. Durbin CG Jr. Early complications of tracheostomy. Respir Care. 2005;50:511-5.
30. 30. Süren M, Balta MG, Taş U, et al. Our experiences deal with percutaneous tracheostomy guided with fiber optic broncoscopy. Çağdaş Tıp Dergisi. 2013;3:17-21.