Maza de la TG, Arzate VJA, Kaneko WFT

Language: Spanish
References: 18
Page: 48-52
PDF size: 62.37 Kb.

ABSTRACT

Background: Percutaneous dilatational tracheostomy (PDT) is an alternative procedure in the airway management of the critically ill patient.
Objective: To evaluate the safety of the PDT performed by the intensivist and analize the cost-benefit of the procedure.
Setting: ICU of a military hospital, Mexico City.
Design: Descriptive study.
Patients: Thirty-five patients were included.
Methods: Age, gender, days of intubation, ICU stay, time of procedure, complications and mortality were registered.
Results: The mean time of the procedure was 13 minutes. The only complication observed was a minimal bleeding in two cases (5.7%). The mortality among patient of this study was 25%. None of this patients died secondary to the procedure.
Conclusions: On the basis ot the low morbility, none mortality and low cost of the PDT in this study, the procedure is a safe alternative method to perform at the bedside of the critically ill patient by the intensivist.

REFERENCES

1. Stedman’s medical dictionary. 25th ed. Baltimore: Williams and Wilkins, 1990:1616.

2. Heffner JE, Miller KS, Sahn SA. Tracheostomy in the intensive care unit: part 1. Indications, technique, management. Chest 1986;90:269-74.

3. Zetouni A, Kost K. Tracheostomy: a retrospective review of 281 cases. J Otolaryngol 1994;23:61-66:

4. Irawan S. Percutaneous tracheostomy in the ICU. Am College of Chest Physicians, www.chesnet.org 1999(13):Lesson 22.

5. Van Heerbeek N, Fikkers B, Van den Hoogen F, Mollen R, Marres H. The guide wire dilating forceps technique of percutaneous tracheostomy. Am J Surg 1999;177:311-315.

6. Ciaglia P, Firshing R, Syniec C. Elective percutaneous dilatational tracheostomy technique: a new simple bedside procedure. Chest 1985;(87):715-19.

7. O’Connor MF. Airway management and tracheostomy in principles of critical care, O’Connor MF, Keami M, Holl JB, editors. 2th. ed. México, Interamericana 1998:111-120.

8. Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest 1989;(96):178-180.

9. Whited RE. A prospective study of laryngotracheal sequelae in long term intubation. Laryngoscope 1984;(94):367-77.

10. Cobean R, Beals M, Moss K et al. Percutaneous dilatational tracheostomy. A Safe, cost-effective bedside procedure. Arch Surg 1996;(131):265.

11. Friedman Y, Mayer AD. Bedside percutaneous tracheostomy in critically ill patients. Chest 1993;(104):532-5.

12. Friedman Y, Fildes J, Mizock B et al. Comparison of percutaneous and surgical tracheostomies. Chest 1996; (110):480-5.

13. Upadhyay y cols. Traqueotomía efectuada en la cama del paciente en la UCI. Critical Care Alert 1997;(7):1-12.

14. Massick DD, Powell DM, Price PD, Chang SL, Squires G, Forrets LA, Young DC. Quantification of the learning curve for percutaneous dilatational tracheostomy. Laryngoscope 2000;110:222-228.

15. Mayberry J, Wu IC, Goldman RK, Chesnut RM. Cervical spine clearance and neck extension during percutaneous tracheotomy in trauma patients. Crit Care Med 2000;(10): 3436-3440.

16. Marx WH, Ciaglia P, Graniero KD. Some importants details in the technique of percutaneous dilatational tracheostomy via the modified Seldinger technique. Chest 1996:(110):762-6.

17. Civetta JM. Prediction and definition of outcome in “Critical Care” editado por Civetta JM, Taylor RW, Kirby RR. ed. 3a. ed. Philadelphia, PA, USA Lippincott-Raven 1997:127-47.

18. Kuhnelt P, Meyer A, Bohning T, Kreymann G. Experience with percutaneous dilatational tracheostomy in 100 medical intensive care units patients. Am J Resp Crit Care Med 2001. 97 International Conferences A-40.