The comparison of early and late percutaneous dilatational tracheostomy in the onset of complications in mechanically ventilated patients in the intensive care unit

Medicina Fluminensis

Ćoza, Petra³  Šustić, Alan¹  Sučić, Neven²  Rukavina, Tomislav⁴  Sotošek Tokmadžić, Vlatka¹  Kuharić, Janja¹  Župan, Željko¹  Ilijanić, Marina³ 

[1] Katedra za anesteziologiju, reanimatologiju i intenzivno liječenje, Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska;Mikrobiološki odjel, Nastavni Zavod za javno zdravstvo Primorsko-goranske županije, Rijeka;Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska;Katedra za socijalnu medicinu i epidemiologiju, Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska

关键词: intensive care unit;    percutaneous dilatational tracheostomy;    ventilator-associated pneumonia;   

DOI  :  

学科分类：医学（综合）

来源: Medicina Fluminensis

【 摘 要 】

Aim: The aim of the study was to determine the incidence and the most common complications of percutaneous dilatational tracheostomy (PDT), compare the effect of early and late PDT on the incidence of ventilator-associated pneumonia, duration of mechanical ventilation and the lenght of stay in critically ill patients treated in the intensive care unit (ICU). Patients and methods: The observational prospective analysis included 338 patients requiring PDT who are treated in ICU Sušak, Clinic of anesthesiology and intensive care, Clinical Hosptial Centre Rijeka in four-years period. Results: One hundred and nine (32 %) patients were women and 229 (68 %) were men. The early PDT was performed in 256 (76 %) patients while the late PDT was performed in 82 (24 %). The complications of PDT were as follows: bleeding occurred in five patients, while hypotension, inflammation of the stoma, injury of larynx, inability to change cannulae, hypoxia and difficult dilatation were identified individually. Comparing the incidence of the complications that occurred in patients receiving early and late PDT, the statistically significant difference was not found in the number of the complications (p = 0.359). The incidence of ventilator-associated pneumonia (p < 0,001), the length of stay in the ICU (p = 0,038), as well as the duration of mechanical ventilation (p = 0,002) were significantly different in patients who received late PDT in comparison to patients in whom early PDT was performed. Discussion and conclusion: The incidence of complications caused by PDT does not depend on the time when PDT is performed. However, early performed PDT shortens the duration of mechanical ventilation and length of stay in ICU, and reduces the incidence of ventilator-associated pneumonia.

【 授权许可】

Unknown