Trakeostomili Olarak Yoğun Bakım Ünitesinden Taburcu Edilen Hastaların Değerlendirilmesi: Tek Merkez Verilerinin Retrospektif Analizi

Amaç: Çalışmamızda, yoğun bakım ünitesi (YBÜ)’nden trakeostomili olarak taburcu edilen olguların 6 aylık süre ile olan takibindeki morbidite ve mortalite nedenlerinin araştırılması amaçlanmıştır. Yöntem: Retrospektif çalışma 35 olguyla tamamlandı. Olguların demografik özellikleri, yatış nedenleri, komorbiditeleri, taburculuktaki Glasgow Koma Skorları (GKS), taburculuk sonrası tekrar hastaneye yatış öyküsünün varlığı, evde mekanik ventilatör desteği (EMVD) olup-olmaması, evde yaşanılan sorunlar, beslenme şekli ve ölüm nedenleri değerlendirildi. Bulgular: İleri yaş, resüsitasyon sonrası bakım gereken hastalar, komorbidite varlığı, EMVD gereksinimi ve PEG ile beslenmenin mortalite ile ilişkili faktörler olduğu belirlendi (p

Assessment of Patients Discharged From the Intensive Care Unit with Tracheostomy: A Retrospective Analysis of Single-Center Data

Objective: The aim of our study was to evaluate the reasons of mortality and morbidity of thepatients who were discharged home from the intensive care unit (ICU) with tracheostomy withina 6-month follow-up period.Method: This retrospective study was completed with 35 patients. The demographic characteristics, indications for hospitalization, comorbidities, Glasgow Coma Scores (GCS) at discharge, history of re-hospitalization after discharge whether there was home mechanical ventilator support(HMVS), problems experienced at home, form of nutrition, and causes of death were assessed.Results: Advanced age, patients requiring care after resuscitation, presence of comorbidity,requirement of HMVS and feeding with PEG were found to be factors related to mortality(p

___

  • 1. Brilli RJ, Spevetz A, Branson RD, et al. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med. 2001;29:2007-19. https://doi.org/10.1097/00003246-200110000-00026
  • 2. Tran DD, Groeneveld AB, van der Meulen J, Nauta JJ, Strack van Schijndel RJ, Thijs LG. Age, chronic disease, sepsis, organ system failure, and mortality in a medical intensive care unit. Crit Care Med. 1990;18:474-9. https://doi.org/10.1097/00003246-199005000-00002
  • 3. Dettmer MR, Damuth E, Zarbiv S, Mitchell JA, Bartock JL, Trzeciak S. Prognostic Factors for Long-Term Mortality in Critically Ill Patients Treated With Prolonged Mechanical Ventilation: A Systematic Review. Crit Care Med. 2017;45:69-74. https://doi.org/10.1097/CCM.0000000000002022
  • 4. Kahn JM, Le T, Angus DC, et al. The epidemiology of chronic critical illness in the United States. Crit Care Med. 2015;43:282-7. https://doi.org/10.1097/CCM.0000000000000710
  • 5. Ambrosino N, Vitacca M. The patient needing prolonged mechanical ventilation: a narrative review. Multidiscip Respir Med. 2018;13:6. https://doi.org/10.1186/s40248-018-0118-7
  • 6. Lloyd-Owen SJ, Donaldson GC, Ambrosino N, et al. Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey. Eur Respir J. 2005;25:1025-31. https://doi.org/10.1183/09031936.05.00066704
  • 7. Povitz M, Rose L, Shariff SZ, et al. Home Mechanical Ventilation: A 12-Year Population-Based Retrospective Cohort Study. Respir Care. 2018;63:380-7. https://doi.org/10.4187/respcare.05689
  • 8. Rose L, McKim DA, Katz SL, et al. Home mechanical ventilation in Canada: a national survey. Respir Care. 2015;60:695-704. https://doi.org/10.4187/respcare.03609
  • 9. Combes A, Luyt CE, Nieszkowska A, Trouillet JL, Gibert C, Chastre J. Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation? Crit Care Med. 2007;35:802-7. https://doi.org/10.1097/01.CCM.0000256721.60517.B1
  • 10. Clec’h C, Alberti C, Vincent F, et al. Tracheostomy does not improve the outcome of patients requiring prolonged mechanical ventilation: A propensity analysis. Crit Care Med. 2007;35:132-8. https://doi.org/10.1097/01.CCM.0000251134.96055.A6
  • 11. Tobin AE, Santamaria JD. An intensivist-led tracheostomy review team is associated with shorter decannulation time and length of stay: A prospective cohort study. Crit Care. 2008;12:R48 https://doi.org/10.1186/cc6864
  • 12. Marchese S, Corrado A, Scala R, Corrao S, Ambrosino N. Intensive Care Study Group, Italian Association of Hospital Pulmonologists (AIPO). Tracheostomy in patients with long-term mechanical ventilation: a survey. Respir Med. 2010;104:749-53. https://doi.org/10.1016/j.rmed.2010.01.003
  • 13. Sovtic A, Minic P, Vukcevic M, Markovic-Sovtic G, Rodic M, Gajic M. Home mechanical ventilation in children is feasible in developing countries. Pediatr Int. 2012;54:676-81. https://doi.org/10.1111/j.1442-200X.2012.03634.x
  • 14. Farré R, Navajas D, Prats E, et al. Performance of mechanical ventilators at the patient’s home: a multicentre quality control study. Thorax. 2006;61:400-4. https://doi.org/10.1136/thx.2005.052647
  • 15. Carson SS, Bach PB, Brzozowski L, Leff A. Outcomes after long-term acute care: an analysis of 133 mechanically ventilated patients. Am J Respir Crit Care Med. 1999;159:1568-73. https://doi.org/10.1164/ajrccm.159.5.9809002
  • 16. Douglas SL, Daly BJ, Brennan PF, Gordon NH, Uthis P. Hospital readmission among long-term ventilator patients. Chest. 2001;120:1278-86. https://doi.org/10.1378/chest.120.4.1278
  • 17. Nathens AB, Rivara FP, Mack CD, et al. Variations in rates of tracheostomy in the critically ill trauma patient. Crit Care Med. 2006;34:2919-24. https://doi.org/10.1097/01.CCM.0000243800.28251.AE
  • 18. Freeman BD, Borecki IB, Coopersmith CM, Buchman TG. Relationship between tracheostomy timing and duration of mechanical ventilation in critically ill patients. Crit Care Med. 2005;33:2513-20. https://doi.org/10.1097/01.CCM.0000186369.91799.44
  • 19. Bickenbach J, Fries M, Offermanns V, et al. Impact of early vs. late tracheostomy on weaning: a retrospective analysis. Minerva Anestesiol. 2011;77:1176-83.
  • 20. Huang H, Li Y, Ariani F, Chen X, Lin J. Timing of tracheostomy in critically ill patients: a meta-analysis. PLoS One. 2014;9:e92981. https://doi.org/10.1371/journal.pone.0092981
  • 21. Masoudifar M, Aghadavoudi O, Nasrollahi L. Correlation between timing of tracheostomy and duration of mechanical ventilation in patients with potentially normal lungs admitted to intensive care unit. Adv Biomed Res. 2012;1:25. https://doi.org/10.4103/2277-9175.98148
  • 22. Heffner JE. The role of tracheotomy in weaning. Chest. 2001;120:477-81. https://doi.org/10.1378/chest.120.6_suppl.477S
  • 23. Metnitz PG, Valentin A, Vesely H, et al. Prognostic performance and customization of the SAPS II: results of a multicenter Austrian study. Simplified Acute Physiology Score. Intensive Care Med. 1999; 25:192-7. https://doi.org/10.1007/s001340050815
  • 24. Doğan R, Başaran B, Pınar HU, Arslan M. To evaluate the clinical outcome in patients discharged for home care with tracheostomy. Turk J Intense Care. 2011;9:99- 102.
  • 25. Kawashima N, Matsumoto A, Narita N. Clinical problems of home mechanical ventilation management for neuromuscular disorders. Gan To Kagaku Ryoho. 1999;26:203-6.
  • 26. Golestanian E, Liou JI, Smith MA. Long-term survival in older critically ill patients with acute ischemic stroke. Crit Care Med. 2009;37:3107-13. https://doi.org/10.1097/CCM.0b013e3181b079b2
  • 27. Marchese S, Lo Coco D, Lo Coco A. Outcome and attitudes toward home tracheostomy ventilation of consecutive patients: a 10-year experience. Respir Med. 2008;102:430-6. https://doi.org/10.1016/j.rmed.2007.10.006
Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
Sayıdaki Diğer Makaleler

Postoperative Neurologic Deficit After Central Neuraxial Anesthesia in a Patient with Preoperative Non-Specific Back Pain

Bahattin TUNCALI, Hakan BOYA, Şükrü ARAÇ

Ultrasonografi ile Deneyimsiz Ellerde Pediyatrik Santral Ven Kateterizasyonu: Ön Rapor

Neslihan ALKIŞ, Gönül KÜÇÜK ERENSU, Gülnur GÖLLÜ BAHADIR, Hüseyin DİNDAR, Çiğdem YILDIRIM GÜÇLÜ, Başak Ceyda MEÇO, Zekeriya ALANOĞLU

Anesthetic Approach to a Patient with Dystrophic Epidermolysis Bullosa: A Case Report

Mürüvvet DAYIOĞLU, Nermin KILIÇARSLAN, Selim Can YIRTIMCI

Palyatif Bakım ve Yoğun Bakım Ünitelerinde Basınç Ülserine Yapılan Geleneksel Pansuman ve Topikal L-Prolin Uygulanmasının Karşılaştırılması

Yeliz ŞAHİNER, Murat KENDİRCİ

Preoperatif Nonspesifik Sırt Ağrısı Olan Bir Hastada Santral Nöraksiyel Blok Sonrasında Postoperatif Nörolojik Defisit

Şükrü ARAÇ, Bahattin TUNCALI, Hakan BOYA

Fonksiyonel Endoskopik Sinüs Cerrahilerinde Optimum Cerrahi Koşulları Sağlamada Kontrollü Hipotansiyon için Deksmedetomidinin Etkinliği: Çift Kör Randomize Kontrollü Çalışma

Soma Ganesh Raja NEETHİRAJAN, Nivash CHANDRASEKARAN, Aruna PARAMESWARİ

The Effect of Gall Bladder Bed Infiltration on Analgesia in Laparoscopic Cholecystectomy

Ibrahim Ibrahim Abd El BASER, Ahmed SADEK, Alaa MAZY

Laparoskopik Kolesistektomide Safra Kesesi Yatağı İnfiltrasyonunun Analjezi Üzerine Etkisi

Ibrahim Ibrahim Abd El BASER, Ahmed SADEK, Alaa MAZY

Distrofik Epidermolisis Bullosalı Hastaya Anestezik Yaklaşım: Olgu Sunumu

Mürüvvet DAYIOĞLU, Nermin KILIÇARSLAN, Selim Can YIRTIMCI

Ultrasonography for Pediatric Central Vein Catheterisation in Inexperienced Hands: A Preliminary Report

Çiğdem YILDIRIM GÜÇLÜ, Gülnur GÖLLÜ, Başak Ceyda MEÇO, Gönül KÜÇÜK, Zekeriya ALANOĞLU, Hüseyin DİNDAR, NESLİHAN ALKIŞ