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Journals / Düzce Tıp Fakültesi Dergisi / 2023 / Volume: 25 Issue: 3

Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes

Yoğun Bakım Ünitesinde Fiberoptik Bronkoskopi Kılavuzluğunda Perkütan Dilatasyonel Trakeostomiye Karşı Klasik Kör Perkütan Dilatasyonel Trakeostomi: Komplikasyonlar, Mortalite ve Sonuçlar

Kadir Arslan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KANUNİ SULTAN SÜLEYMAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0003-4061-0746
Ebru Kaya(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KANUNİ SULTAN SÜLEYMAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0002-9506-0756
Ayça Sultan Şahin(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KANUNİ SULTAN SÜLEYMAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0002-7765-5297
Pages
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Publication Date
2023-12-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: In PDT procedures performed under FOB guidance, procedure time, length of stay in the ICU, and procedure-related complication rates were significantly lower, while no significant difference was observed in terms of mortality.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study aimed to compare percutaneous dilatational tracheostomy (PDT) procedures performed with fiberoptic bronchoscopy (FOB) guidance and classical blind technique regarding complications, mortality, and patient outcomes.
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Key Findings & Data:Material and Methods: This study included 62 patients receiving mechanical ventilator support in the intensive care unit (ICU) between October 2022 and June 2023.
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Conclusion & Impact:Conclusion: In PDT procedures performed under FOB guidance, procedure time, length of stay in the ICU, and procedure-related complication rates were significantly lower, while no significant difference was observed in terms of mortality.
🔬Design:Research Article
📍Scope:2022 Verileri
⚙️Variables:Tracheostomy · Bronchoscopy · Intensive care unit

Abstract

Aim: This study aimed to compare percutaneous dilatational tracheostomy (PDT) procedures performed with fiberoptic bronchoscopy (FOB) guidance and classical blind technique regarding complications, mortality, and patient outcomes. Material and Methods: This study included 62 patients receiving mechanical ventilator support in the intensive care unit (ICU) between October 2022 and June 2023. Patients were randomized into two groups: those who underwent FOB-guided PDT (group FOB, n=31) and those who underwent PDT with the classical blind technique (group C, n=31). Demographic data, clinical characteristics, PDT procedure times, complications, and mortalities were analyzed. Results: The median age was 64 (range, 19-94) years, and 67.7% (n=42) of the patients were male. Demographic data were found similar between groups. The most common primary diagnosis in patients who underwent PDT was intracranial hemorrhages (32.3%, n=20). While the median tracheostomy opening time in the entire study group was 13 (range, 3-31) days, there was no significant difference between the groups (p=0.637). The mean PDT procedure time (9.6±3.8 vs 12.6±5.4 min, p=0.015), median ICU stay (26 vs 37 days, p=0.004), and complication rate (6.4% vs 25.8%, p=0.038) were found to be significantly lower in group FOB. While the 28-day mortality in the entire study group was 17.7% (n=11), there was no significant difference between the groups (p=0.740). Conclusion: In PDT procedures performed under FOB guidance, procedure time, length of stay in the ICU, and procedure-related complication rates were significantly lower, while no significant difference was observed in terms of mortality.

Özet

Amaç: Bu çalışmanın amacı, fiberoptik bronkoskopi (FOB) kılavuzluğu ile klasik kör teknikle gerçekleştirilen perkütan dilatasyonel trakeostomi (PDT) işlemlerinin komplikasyonlar, mortalite ve hasta sonuçları açısından karşılaştırılmasıdır. Gereç ve Yöntemler: Bu çalışmaya Ekim 2022 ile Haziran 2023 tarihleri arasında yoğun bakım ünitesinde (YBÜ) mekanik ventilatör desteği alan 62 hasta dahil edildi. Hastalar FOB kılavuzluğunda PDT gerçekleştirilenler (grup FOB, n=31) ve klasik kör teknikle PDT gerçekleştirilenler (grup C, n=31) olarak iki gruba randomize edildi. Demografik veriler, klinik özellikler, PDT işlem süreleri, komplikasyonlar ve mortaliteler analiz edildi. Bulgular: Ortanca yaş 64 (aralık, 19-94) yıl ve hastaların %67,7’si (n=42) erkek idi. Gruplar arasında demografik verilerin benzer olduğu saptandı. PDT işlemi gerçekleştirilen hastalarda en sık primer tanı intrakranyal hemorajiler (%32,3; n=20) idi. Tüm çalışma grubunda medyan trakeostomi açılma zamanı 13 (aralık, 3-31) gün iken gruplar arasında anlamlı bir farklılık yoktu (p=0,637). Ortalama PDT işlem süresi (9,6±3,8’e karşı 12,6±5,4 dakika, p=0,015), ortanca YBÜ kalış süresi (26’ya karşı 37 gün, p=0,004) ve komplikasyon oranı (%6,4’e karşı %25,8; p=0,038) grup FOB’da anlamlı olarak daha düşük saptandı. Tüm çalışma grubunda 28 günlük mortalite %17,7 (n=11) iken gruplar arasında anlamlı bir farklılık yoktu (p=0,740). Sonuç: FOB kılavuzluğunda gerçekleştirilen PDT işlemlerinde, işlem süresi, YBÜ kalış süresi ve işleme bağlı görülen komplikasyon oranları anlamlı olarak düşük saptanırken, mortalite açısından anlamlı bir farklılık görülmedi.

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Cite This Article

Arslan, K., Kaya, E., Şahin, A. S. (2023). Classical Blind Percutaneous Dilatational Tracheostomy vs Fiberoptic Bronchoscopy Guided Percutaneous Dilatational Tracheostomy in the Intensive Care Unit: Complications, Mortality, and Outcomes. Düzce Tıp Fakültesi Dergisi, Volume: 25 Issue: 3. https://doi.org/10.18678/dtfd.1350474

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