LATE OUTCOME OF PERCUTANEOUS DILATATIONAL TRACHEOSTOMY IN INTENSIVE-CARE PATIENTS

被引：47

作者：

FISCHLER, MP

KUHN, M

CANTIENI, R

FRUTIGER, A

机构：

[1] RAT KANTONS & REG SPITAL,INTERDISCIPLINARY INTENS CARE UNIT,CH-7000 CHUR,SWITZERLAND

[2] RAT KANTONS & REG SPITAL,PULM SERV,CH-7000 CHUR,SWITZERLAND

来源：

INTENSIVE CARE MEDICINE | 1995年 / 21卷 / 06期

关键词：

TRACHEOSTOMY; METHODS; ICU; POSTOPERATIVE COMPLICATIONS; FOLLOW-UP STUDIES;

D O I：

10.1007/BF01706200

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. Design: Prospective descriptive clinical study. Setting: Interdisciplinary intensive care unit in a 300-bed teaching hospital. Patients: A consecutive group of critically ill patients who underwent percutaneous tracheostomy between Nov. 90 and March 93, surviving at least 2 months after decannulation. Measurements and results: There were 17 patients fulfilling the inclusion criteria and 16 of them were seen and examined. The follow-up protocol required a formal standardized patient interview, a physical examination of the stoma site and a fiberoptic laryngotracheoscopy. Results of these sub-tests and overall outcome rating were standardized and expressed as good, moderate or poor. Subjective rating was good in all patients. All denied suffering from any side effects of their tracheostomy. Clinical examination revealed neither strider nor hoarseness in any of the patients. Most of the scars were whitish and less than 1 cm in length, a few were sunken in, none had adhesions. In 15 patients the clinical result was good and in one, moderate (whitish, sunken-in scar, longer than 2 cm). Ten patients underwent tracheoscopy, while 6 did not. There were no signs of significant stenosis or tracheomalacia. In and patients with minor findings results were scored as good, while 2 were classified as moderate (combination of swelling and scar formation of a string-like membrane). The overall rating was good in 13 patients (81%) and moderate in 3 patients (19%). There were no poor outcomes. Conclusions: Late outcome of percutaneous dilatational tracheostomy in critically ill patients is mostly good. Pending further studies, the use of this technique in intensive care units appears justified.

引用

页码：475 / 481

页数：7

共 32 条

[1]

Ciaglia P., Firsching R., Syniec C., Elective percutaneous dilatational tracheostomy: a new simple bedside procedure

[2]

Preliminary report, Chest, 87, pp. 715-719, (1985)

[3]

Hazard P., Jones C., Benitone J., Comparative clinical trial of standard operative tracheostomy with percutaneous tracheostomy, Crit Care Med, 19, pp. 1018-1024, (1991)

[4]

Schachner A., Ovil Y., Sidi J., Rogev M., Heilbronn, Percutaneous tracheostomy — a new method, Crit Care Med, 17, pp. 1052-1056, (1989)

[5]

Griggs W.M., Worthley L.I.G., Gilligan J.E., Thomas P.D., Myburg J.A., A simple percutaneous tracheostomy technique, Surgey, 170, pp. 543-545, (1990)

[6]

Hazard P.B., Garrett H.E., Ada J.W., Robbins E.T., Aguillard R.N., Bedside percutaneous tracheostomy: experience with 55 elective procedures, Ann Thorac Surg, 46, pp. 63-67, (1988)

[7]

Worthley L.I.G., Holt A., Percutaneous tracheostomy, Intensive Care World, 9, pp. 187-192, (1992)

[8]

Rohrer R., Reigner M., Frutiger A., Die perkutane Dilatationstracheostomie nach Ciaglia: Eine zweckmäßige Alternative auf der Intensivstation, Schweiz Med Wochenschr, 122, (1992)

[9]

Waldron J., Padgham N.D., Hurley S.E., Complications of emergency and elective tracheostomy: a retrospective study of 150 consecutive cases, Ann R Coll Surg Engl, 72, pp. 218-220, (1990)

[10]

Griggs W.M., Myborgh J.A., Worthley L.I.G., A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy, Intensive Care Med, 17, pp. 261-263, (1991)

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