The evaluation of the complications of surgical and percutaneous tracheostomies in intensive care unit [Yo?un baki{dotless}m ünitesinde yapi{dotless}lan cerrahi ve perkütan trakeostomilerin komplikasyonlar yönünden de?erlendirilmesi]

Abstract

Objective: In the last 3 years, intensive care unit patients who had under-gone percutaneous tracheostomy and surgical tracheostomy retrospectively were evaluated to determine the differences between the two methods in terms of complications. Methods: Patients who had been hospitalised in the intensive care unit in the last 3 years, with ages ranging from 18-65, who were intubated and had undergone tracheostomy were included in the study. Patients were divided into two groups: those with percutaneous tracheostomy and those with surgical tracheostomy. From the last 3 years, patients who had full data in the file were included in the study; the number of patients with surgical tracheostomy was 104, and the number of patients with percutaneous tracheostomy was 99. All data were obtained from patient charts, forms, and daily patient follow-up examination forms. Demographic characteristics of the patients and the Glasgow Coma Scale (GCS) data were recorded from the patient file and haemodynamic data, blood gas values, haemoglobin values of before and 1 day after the procedure were recorded. Any additional complications were also recorded. Results: Haemoglobin values after the procedure were significantly lower than values before the initiation of procedure in the surgical tracheostomy group but not in the percutaneous tracheostomy group. In the surgical tracheostomy group, 20 of 104 patients had bleeding after the procedure; there was repetition of endotracheal intubation in 22 patients during the acute phase, and subcutaneous emphysema was observed in 18. Bleeding was recorded in patients with percutaneous tracheostomy in 5 out of 99 patients, repetition of endotracheal intubation was performed in 7, and subcutaneous emphysema was observed in 5. Conclusion: The percutaneous tracheostomy technique, in terms of postoperative complications and bleeding, gives better results than surgical tracheostomy and could be used widely as a routine method for elective tracheostomy in intensive care units. © 2013 by Turkish Anaesthesiology and Intensive Care Society.