DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20203191

Indications and outcomes of tracheostomy in intensive care unit

Mukhlesur Rahman, Mahmuda Begum, Mujibul Hoque Khan, Mostsfa Mahfuzul Anwar

Abstract


 

Background: Tracheostomy is a commonly performed surgical procedure in the intensive care unit (ICU) in which creation of a stoma between the skin and the anterior wall of the trachea where there is need for prolong mechanical ventilation. Tracheostomy has considered a safe procedure in ICU but has been found to lead to life threatening complications intra and post operatively.

Methods: This is a cross sectional study, was carried out in ICU, Chittagong Medical College Hospital, Chattogram from January 2018 to December 2019. A total of 120 patients irrespective of age and sex whose tracheostomy has done after admission in ICU by ENT surgeons.  

Results: Out of 120 patients maximum 34 (28.33%) were from 21-30 years age group and male to female ratio was 1.79:1, male patients were 77 (64.16%) and female patients were 43 (35.83%). The most common indication for tracheostomy in ICU was head injury and history of RTA 34 (28.33%) followed by post-operative case of intracranial space occupying lesion 30 (25%). Post tracheostomy complication was surgical emphysema 4 (3.33%). The rate of complication of tracheostomy in ICU was 10.83% in this study. Regarding benefits of tracheostomy over endotracheal tube in ICU, we found that 100% patients had greater comfort.

Conclusions: Tracheostomy in ICU is an important and safe procedure if prolonged endotracheal in tubation is advised for varying underlying causes.


Keywords


Tracheostomy, Intensive care unit, Outcome

Full Text:

PDF

References


Caroline HI, Lima BL, Sato J, Fujuta RR. Indication and complication of tracheostomy. Braz J Otorhinolaryngology. 2010;76:3-10.

Upadhyay A, Maurer J, Turner J, Tiszenvel H, Rosengart T. Elective bedside tracheostomy in intensive care unit. J American College Surg. 1996;183(1):51-5.

Esbeban A, Anzueto A, Alia I, Gordo F, Apezteguia C, Palizas F, et al. How is mechanical ventilation employed in the intensive care unit: an international utilization review. Am J Respiratory Crit Care Med. 2000;161:1450-8.

Muralidhar K. Tracheostomy in ICU: An insight into the present concepts. Indian J Anaesthesia. 2008;52(1):28.

Bary B, Bodenhan AR. Role of tracheostomy in ICU, Anaesthesia and intensive care medicine. Annals Intensive Care. 2004;5(11):375-8.

Whorter MA. Tracheostomy timing and techniques. Curr Opin Otolaryngol Head Neck Surg. 2003;11(6):473-9.

Stock MC, Ward WCA, Shapiro BA. Peri-operative complications of elective tracheostomy in critically ill patients. Crit Care Med. 1986;14:861-3.

Bradley PJ. Management of obstructive airway and tracheostomy. In: Scolt Brown’s otolaryngology. Reed educational and professional publishing Ltd, Oxford, Great Britain. 1997 (6th Edition); page 5/7/1-20.

Chowdhury AA, Sultana T, Joarder AH, Tarafder KH. A comparative study of elective and emergency tracheostomy. Bangladesh J Otorhinolaryngology. 2008;14(2):57-62.

Blot F, Similowski T, Trouillet JL, Chardon P, Korach JM, Costa MA, et al. Early tracheostomy versus prolonged endotracheal intubation in unselected severly ill ICU patients. Intensive Care Med. 2008;34(10):1779-87.

Nieszkowska A, Combes A, Luyt CE, Ksibi H, Trouillet JL, Gilbert C, et al. Impact of tracheostomy on sedative administration, sedative level and comfort of mechanically ventilated intensive care unit patents. Crit Care Med. 2005;33(11): 2527-33.

Griffiths J, Barber VS, Morgan L, Young JD. Systemic review and meta-analysis of studies of the timing of Tracheostomy in adult patients undergoing artificial ventilation. BMJ. 2005;330(7502):1243.

Mohmud M, Hossain MA, Sarkar MZ, Hossain HSM, Islam MO, Ahmed MU, et al. Tracheostomy in intensive care unit. Indication, Benefits and complications. Bangladesh J Otorhinolaryngology. 2015;21(1):28-32.

Shekar CY, Viswanatha B, Srinivasan SB, Joyaram RT, Vijayashree MS. tracheostomy in intensive care unit: Indications and out comes at a teaching Hospital. J Otolaryngology. 2016;5(2):28-31.

Perfeito JAJ, Forte V, camaghi M, Tamuran N. Jornal Brasilerio de pneumologia: tracheostomy in ICU: it is worthwhile. Bangladesh Crit Care J. 2007;3(6):1-5.

Centre for the Rehabilitation of the paralysed. Road safety in Bangladesh; 2010.

Datta RK, Viswanatha B, Puneet PJ, Meerin B, Kumari TLN. Tracheostomy: Our Experience Research in otolaryngology. 2015;4(2):29-33.

Rahman SH, Ahmed K, Khan AFM, Ahmed SU, Hanif MA, Haroon AA, et al. Study of tracheostomy in Dhaka medical College Hospital. Bangladesh J Otorhinolaryngology. 2001;7(2):34-40.

Ahmed K, Rahinan MA, Rahman SH. Complication of tracheostomy. Bangladesh J Otorhinolaryngology. 1998;4(1):3-6.

Manuel L, Mark O. Tracheal obstruction as a complication of tracheostomy tube malfunction; case report and review of the literature. J Bronchology Interventional Pulmonology. 2010;77:253-7.

Ashwin MA, Deepa R, Balakrishnan E, Aswin M, Anupama M. Tracheostomy: a hospital based descriptive study. Medplus Int J ENT. 2017;1(2):33-9.