May 2, 2009

Percutaneous tracheotomy and cricothyroidotomy in the critical patient

Medicina intensiva
L Marruecos-SantGrupo de Trabajo del Protocolo Institucional de Traqueotomías del Hospital de la Santa Creui Sant Pau

Abstract

To review and compare the complications of percutaneous tracheotomy (TP) and cricothyroidotomy (CT) used to perform tracheal intubation in patients requiring prolonged mechanical ventilation. A prospective, observational study performed from October 2004 to October 2006, and follow-up of course until May 2007. Intensive care service from a university-affiliated teaching hospital. A total of 82 patients in which CT or TP were necessary. Forty-three TP and 39 CT were performed. Reason for TP or CT, demographic data, severity scores, ICU length of stay, orotracheal intubation (OTI) days, CT/TP early and late complications and in-hospital evolution were collected. TP/CT were performed due to prolonged ventilation in 62 (76%) patients and because of impaired neurological status in the remaining patients. There were no differences between TP/CT in gender, APACHE II, ICU length of stay, previous OTI days. Patients in the CT group were older (68 +/- 9 vs 54 +/- 15 years, p < 0.001). There were 5 mild adverse events (3 guide angulations and 2 lateral tracheal punctions) after TP, and 1 severe adverse event (pulmonary ventilation problem) after CT. There were no fatal event related with TP/CT. Thirty-four patients were decanulated. Mild ...Continue Reading

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Mentioned in this Paper

Trachea
Subglottic
Adverse Event
Intubation, Intratracheal
Observation - Diagnostic Procedure
Tracheotomy Procedure
Specialty Type - Intensive Care
Ventilation, Function (Observable Entity)
Respiration
Granuloma

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