Yoğun Bakım Ünitemizde Perkütan Yöntemle Açılan Trakeostomi Deneyimlerimiz; Retrospektif Analiz

ÖZ. Amaç: Yoğun bakım ünitemizde perkütan trakeostomi yöntemi ile açılan 58 hastayı retrospektif olarak sunmayı amaçladık. Materyal ve metod: Hastanemizin anesteziyoloji ve reanimasyon kliniği yoğun bakım ünitesinde Ocak 2017-Aralık 2020 tarihleri arasında perkütan yöntemle trakeostomi açılan hastalar retrospektif olarak incelendi. Bulgular: Çalışmaya 58 hasta dahil edildi. Hastaların yaş ortalaması 65±18,2 yıl idi. Hastaların %56,9’i erkek, % 43,1’i kadındı. Yatış tanılarına bakıldığında en sık neden nörolojik nedenler idi. Hastaların Apache II skorları ortalama 23,2±3,6 olarak bulundu. Hastaların PT açılmasına kadar geçen süre ortalama 18,3±5,1 gün, PT açılma süresi 11,1±2,4 dk, mekanik ventilatör süreleri 62,1±37,8 gün ve yoğun bakım yatış süresi 67,2±43,5 gün olarak bulundu. İşlem sırasında en sık görülen komplikasyon hipoksi ve hipotansiyon iken işlem sonrasında görülen en sık komplikasyon minör kanama olarak saptandı. Sonuç: Trakeostominin, hasta konforunu artırmak, hastaların solunum cihazından ayrılmalarını kolaylaştırmak, ölü boşluğu azaltarak pulmoner sekresyonların temizlenmesini sağlamak gibi avantajları bulunmaktadır. Perkütan trakeostomi düşük komplikasyon oranları nedeniyle daha güvenilir bir işlemdir. ABSTRACT Background: To retrospectively evaluate 58 patients who underwent percutaneous tracheostomy in our intensive care unit. Materials and Methods: The study included 58 patients that underwent percutaneous tracheostomy in the ICU at our Anesthesiology and Reanimation department between January 2017 and December 2020. Results: The percutaneous tracheostomy group comprised 33 (56.9%) men and 25 (43.1%) women with a mean age of 65±18.2 (range, 19-90) years. Most common primary diagnosis of hospitalization was neurological disorders (51.7%). Mean APACHE II score was 23.2±3.6, mean time to percutaneous tracheostomy was 18.3±5.1 (range, 7-30) days, mean procedural time was 11.1±2.4 min, mean duration of mechanical ventilation was 62.1±37.8 (range, 15-167) days, mean intensive care unit stay was 67.2±43.5 (range, 15-247) days, and mean hospitalization time was 77.5±50.4 (range, 15-277) days. Hypoxia and hypotension were the most common intraoperative complications and minor bleeding was the most common postoperative complication. Conclusions: Performing early tracheostomy in intensive care unit patients requiring prolonged mechanical ventilation increases patient comfort, facilitates discontinuation of mechanical ventilation, reduces the dead space, facilitates the clearing of airway secretions, and shortens the duration of intensive care unit and hospital stay. Additionally, percutaneous tracheostomy was revealed as a safe procedure for intensive care unit patients due to its lower complication rates.

Anahtar Kelimeler:

Perkütan trakeostomi, komplikasyon, yoğun bakım

Our Percutaneous Tracheostomy Experience in Our Intensive Care Unit: A Retrospective Analysis

Background: To retrospectively evaluate 58 patients who underwent percutaneous tracheostomy in our intensive care unit.Materials and Methods: The study included 58 patients that underwent percutaneous tracheostomy in the ICU at our Anesthesiology and Reanimation department between January 2017 and December 2020.Results: The percutaneous tracheostomy group comprised 33 (56.9%) men and 25 (43.1%) women with a mean age of 65±18.2 (range, 19-90) years. Most common primary diagnosis of hospitalization was neurological disorders (51.7%). Mean APACHE II score was 23.2±3.6, mean time to percutaneous tracheostomy was 18.3±5.1 (range, 7-30) days, mean procedural time was 11.1±2.4 min, mean duration of mechanical ventilation was 62.1±37.8 (range, 15-167) days, mean intensive care unit stay was 67.2±43.5 (range, 15-247) days, and mean hospitalization time was 77.5±50.4 (range, 15-277) days. Hypoxia and hypotension were the most common intraoperative complications and minor bleeding was the most common postoperative complication.Conclusions: Performing early tracheostomy in intensive care unit patients requiring prolonged mechanical ventilation increases patient comfort, facilitates discontinuation of mechanical ventilation, reduces the dead space, facilitates the clearing of airway secretions, and shortens the duration of intensive care unit and hospital stay. Additionally, percutaneous tracheostomy was revealed as a safe procedure for intensive care unit patients due to its lower complication rates.

Keywords:

Percutaneous tracheostomy, complication, intensive care unit,

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