Indication, complication, and prognosis of fiberoptic bronchoscopy guided percutaneous dilatation tracheostomy opening in respiratory intensive care unit: a retrospective study.
Eur Rev Med Pharmacol Sci
; 27(24): 11771-11779, 2023 Dec.
Article
in En
| MEDLINE
| ID: mdl-38164840
ABSTRACT
OBJECTIVE:
Percutaneous dilatational tracheostomy (PDT) is a bedside applicable procedure in intensive care unit patients requiring long-term mechanical ventilation. Fiber optic bronchoscopy (FOB) makes it easier and reduces complications. Our study aimed to evaluate the indications, complications, and prognosis of PDTs performed with FOB. PATIENTS ANDMETHODS:
Our study included 114 patients undergoing PDT through FOB-guided Griggs method in the Respiratory Intensive Care Unit between January 01, 2018, and January 31, 2023.RESULTS:
Among the patients undergoing PDT with FOB, 81 (71.1%) were male. The mean age was 62.1±11.5. The median Glasgow Coma Scale (GCS) score was 9, the median Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score was 19, and the median Sequential Organ Failure Assessment (SOFA) score was 8. Tracheostomy was opened for prolonged mechanical-ventilator requirement in 80 patients (70.2%), to protect the airway in 19 (16.7%), and for poor neurologic status in 15 patients (13.2%). Complications during the procedure included hypoxemia in 3 patients (2.6%), minor bleeding in 3 patients (2.6%), perforation of the FOB in one patient (0.8%), and perforation of the intubation tube cuff in one patient (0.8%). 79 patients (69.3%) were discharged, and 35 (30.7%) were exited. There was a significant difference between the GCS, APACHE-II, and SOFA scores of the patients discharged and those who exited (p < 0.001).CONCLUSIONS:
FOB-guided PDT application should be encouraged as it reduces complications but it is still limited because it requires experienced specialists and equipment for a standard approach.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bronchoscopy
/
Tracheostomy
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur Rev Med Pharmacol Sci
Journal subject:
FARMACOLOGIA
/
TOXICOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Country of publication: