Tracheostomy - Analysis of a Six-Year Period

Overview

The authors present a retrospective analysis of results and complications of electivetracheostomy interventions performed in the period of January 1998 till December 2003 at theintensive care units of General Teaching Hospital in Prague. The cohort included 543 patients, 309men and 234 women. In the period of observation, 430 standard surgical interventions and 113puncture dilatation tracheostomy interventions were performed. In two cases the puncture dilatationtracheostomy was converted into standard one. The standard surgical tracheostomy interventionswere by otolaryngologists, in the puncture dilatation tracheostomy interventions theparticipating physicians were intensive care specialists and an otolaryngologist. Themost frequentlyrepresented group of patients was between 61 and 80 years of life, representing 285 individuals(52.4%). Themost frequent indication for tracheostomywas the necessary artificial lung ventilationand providing conditions for cleaning respiratory pathways. The average period of endotrachealintubation before tracheostomy was seven days (rage 13 minutes to 21 days). For the period of 71months the cannula was removed in 167 patients (30.7%), 78 patients (14.3%) continue to carry thecannula and 298 (54.8%) of patients carrying cannula died for complications of basic disease.The postoperation complications included those, which evolved during the intervention or in thesubsequent 24 hours. In the standard surgical technique the peroperation complications occurredfive times (0.9%). In the puncture dilatation tracheostomy the peroperation complications occurred13 times (2.3%). The early postoperation complications are considered to be those, which occurredon day 2 to 7 after the intervention. In the standard surgical tracheostomy these were encountered33 times (6%) and in the puncture dilatation technique 21 times (3.9%). The late postoperationcomplications included those, which occurred seven days after the intervention or later. Thesewereobserved 6 times (1.1%) in standard surgical tracheostomy and once (0.1%) in puncture dilatationintervention.

Key words:
standard surgical tracheostomy, puncture dilatation tracheostomy, artificial lungventilation.