Eylem YASAR, Semra GÜMÜŞ DEMİRBİLEK, Ezgi DÖNMEZ

Perkütan Dilatasyonel Trakeostomi Sırasında Bronkoskopi Rehberliğinde ProSeal Laringeal Maske Kullanımı

Amaç: Bu çalışmada birincil amacımız, bronkoskopi eşliğinde perkütan dilatasyonel trakeostomi (PDT) işleminde ProSeal larin- geal maske (P-LMA) ve endotrakeal tüp (ETT) kullanımı arasındaki komplikasyon oranlarını karşılaştırmaktır. İkincil amacımız ise bu iki tekniğin işlem sürelerini karşılaştırmak. Yöntem: Çalışmaya, yoğun bakım ünitesinde entübe edilen ve uzun süreli mekanik ventilasyon ihtiyacı nedeniyle PDT planlanan 61 erişkin hasta dahil edildi. Hastalar rastgele ETT grubuna veya bronkoskopi rehberliğinde P-LMA grubuna ayrıldı. İşlemlere ilişkin komplikasyonlar ve her işlemin süresi kaydedildi. Perkütan dilatasyonel trakeostomi öncesi ve işlemden 30 dakika sonraki hemodinamik ölçümler, oksijen satürasyonu, arter kan gazı analizi, tercih edilen mekanik ventilasyon modu, pozitif end ekspiratuar basınç ve ortalama hava yolu basıncı değerleri kaydedildi. Bulgular: Çalışmaya 23 (%38) kadın ve 38 (%62) erkek olmak üzere toplam 61 olgu katıldı. Gruplar arası komplikasyon oranlarına bakıldığında, ETT grubunda daha fazla komplikasyonla karşılaştık ve en sık karşılaşılan komplikasyon entübasyon tüpünün kafının delinmesi idi. İşlem süresi de P-LMA grubunda anlamlı olarak daha kısaydı (P-LMA; 2,5 dak, ETT; 3,6 dak). Sonuç: Bronkoskopi eşliğinde yapılan perkütan dilatasyonel trakeostomi işleminde P-LMA ve ETT kullanımını karşılaştırdığımız çalışmamızda P-LMA grubunda entübasyona oranla komplikasyon oranının daha az olduğu, işlem süresinin daha kısa olduğu bulunmuştur.

Use of ProSeal Laringeal Mask Airway Under Bronchoscopy Guidance During Percutaneous Dilatational Tracheostomy

Objective: In the current study, our primary aim is to compare complication rates between using ProSeal laryngeal mask airway (P-LMA) and endotracheal tube (ETT) in bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) procedure. Our secondary aim is to compare the processing time of these two techniques. Methods: Sixty-one adult patients who were intubated in the intensive care unit and scheduled for PDT due to the need for long-term mechanical ventilation were included in the study. The patients were randomly divided into ETT group or P-LMA group under bronchoscopy guidance. Complications related to the procedures and the duration of each procedure were recorded. Hemodynamic measurements, oxygen saturation, arterial blood gas analysis, preferred mechanical ventilation mode, positive end expiratory pressure and mean airway pressure values were recorded before PDT, and 30 minutes after the procedure. Results: A total of 61 cases, 23 (38%) female and 38 (62%) male, participated in the study. Regarding the complication rates between the groups, we encountered more complications in the ETT group and the most common complication was puncture of the cuff of the intubation tube. The procedure time was also significantly shorter in the P-LMA group (P-LMA; 2.5 min, ETT; 3.6 min). Conclusion: Using P-LMA for PDT under bronchoscopy caused lower complication rate than using ETT. In a addition the duration of PDT procedure was shorter in P-LMA group than ETT group.

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