AI Summary & Key Takeaways
AI InsightConclusion: The percutaneous tracheostomy technique, in terms of post- operative complications and bleeding, gives better results than surgical tracheostomy and could be used widely as a routine method for elective tracheostomy in intensive care units.
📌 3 Key Takeaways
Abstract
Objective: In the last 3 years, intensive care unit patients who had under- gone percutaneous tracheostomy and surgical tracheostomy retrospective- ly were evaluated to determine the differences between the two methods in terms of complications. Methods: Patients who had been hospitalised in the intensive care unit in the last 3 years, with ages ranging from 18-65, who were intubated and had undergone tracheostomy were included in the study. Patients were divided into two groups: those with percutaneous tracheostomy and those with surgical tracheostomy. From the last 3 years, patients who had full data in the file were included in the study; the number of patients with surgical tracheostomy was 104, and the number of patients with percuta- neous tracheostomy was 99. All data were obtained from patient charts, forms, and daily patient follow-up examination forms. Demographic char- acteristics of the patients and the Glasgow Coma Scale (GCS) data were recorded from the patient file and haemodynamic data, blood gas values, haemoglobin values of before and 1 day after the procedure were recorded. Any additional complications were also recorded. Results: Haemoglobin values after the procedure were significantly lower than values before the initiation of procedure in the surgical tracheostomy group but not in the percutaneous tracheostomy group. In the surgical tracheostomy group, 20 of 104 patients had bleeding after the procedure; there was repetition of endotracheal intubation in 22 patients during the acute phase, and subcutaneous emphysema was observed in 18. Bleeding was recorded in patients with percutaneous tracheostomy in 5 out of 99 patients, repetition of endotracheal intubation was performed in 7, and subcutaneous emphysema was observed in 5. Conclusion: The percutaneous tracheostomy technique, in terms of post- operative complications and bleeding, gives better results than surgical tracheostomy and could be used widely as a routine method for elective tracheostomy in intensive care units.
Özet
Amaç: Yoğun bakım ünitemizde son 3 yıl içinde perkütan trakeostomi ve cerrahi trakeostomi uygulanmış hastalar geriye dönük olarak değerlendi- rilerek komplikasyonlar yönünden her iki yöntemin farklılıklarının belir- lenmesi amaçlandı. Yöntemler: Çalışmaya son 3 yıllık dönemdeki yaşları 18-65 arasında deği- şen, yoğun bakımda entübe olarak yatmakta olan trakeostomi açılmış has- talar dahil edildi. Hastalar perkütan trakeostomi açılmış olanlar ve cerrahi trakeostomi açılmış olanlar olarak iki gruba ayrıldı. Son 3 yıl içinde trake- ostomi açılan ve dosyada aranan verileri tam olarak bulunarak çalışmaya dahil edilen cerrahi trakeostomili hasta sayısı 104, perkütan trakeostomi açılan hasta sayısı ise 99 olarak bulundu. Tüm bilgiler hasta dosyaların- dan, tetkik formlarından ve günlük hasta takip formlarından elde edildi. Hastaların demografik özellikleri ve glasgow koma skalası (GKS) verileri kaydedildi, işlem öncesi ve işlemden 1 gün sonrası hemodinamik verileri, kan gazı değerleri, hemoglobin, gibi veriler hasta dosyasından kaydedildi. İşlem sonrasında gelişen komplikasyonlar kaydedildi. Bulgular: Cerrahi trakeostomi grubunda işlem sonrası hemoglobin değer- leri perkütan trakeostomi grubuna göre anlamlı derecede düşük bulundu. Cerrahi trakeostomi açılmış 104 hastadan 20sinde işlem sonrası kanama, 22sinde akut dönemde endotrakeal entübasyon tekrarı, 18inde cilt altı amfizem gözlendi. Perkütan trakeostomi hastalarından 99 hastanın 5inde kanama, 7sinde endotrakeal entübasyon tekrarı, 5inde cilt altı amfizem gözlendi. Sonuç: Perkütan trakeostomi yönteminin postoperatif komplikasyonlar ve kanama yönünden cerrahi trakeostomi yöntemine göre daha iyi sonuçlar verdiği ve yoğun bakımlarda trakeostomi yöntemi olarak yaygın şekilde kullanılabileceği kanaatindeyiz.