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Comparative study of percutaneous dilatational tracheostomy and conventional tracheostomy in the intensive care unit

机译:重症监护病房经皮扩张气管切开术与常规气管切开术的比较研究

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摘要

>Objective: Tracheostomy is a one of the earliest described surgical procedure dating back to 2000 B.C. Percutaneous tracheostomy is becoming increasingly popular as an alternative method for conventional tracheostomy in the intensive care unit. In this study we compare the results of the use of these 2 techniques in 32 patients who underwent elective tracheostomy in the intensive care unit.>Study Design: Prospective randomized comparative study.>Setting: Tertiary care hospital.>Patients: Adult intubated patients selected randomly in the intensive care unit with normal cervical soft tissue, laryngeal framework, palpable cricoid cartilage and normal coagulation parameters.>Results: 17 patients underwent conventional tracheostomy and 15 patients underwent percutaneous dilatational tracheostomy. Demographic data and duration of intubation comparable between two groups. The mean operative time, blood loss and complications were lower in percutaneous than in conventional tracheostomy.>Conclusions: PDT is quicker to perform and has lower blood loss and complication rates compared to conventional tracheostomy. However percutaneous tracheostomy is not indicated in emergencies and in children. The cost of the percutaneous kit and use of bronchoscopy adds to the cost. It is a good alternative to conventional tracheostomy in properly selected patients.
机译:>目的:气管切开术是最早可追溯到公元前2000年的外科手术之一。经皮气管切开术作为重症监护病房常规气管切开术的替代方法正变得越来越普遍。在这项研究中,我们比较了这两种技术在32例重症监护病房择期气管切开术中的使用效果。>研究设计:前瞻性随机比较研究。>设置 :三级医院。>患者:在重症监护病房中随机选择的成人插管患者,其颈部软组织正常,喉框架,可触及的环状软骨且凝血指标正常。>结果: 17例行常规气管切开术,15例行经皮扩张气管切开术。两组的人口统计学数据和插管持续时间相当。经皮穿刺术的平均手术时间,失血量和并发症比常规气管切开术要低。>结论:与传统的气管切开术相比,PDT的执行速度更快,失血量和并发症发生率更低。但是,在紧急情况和儿童中未进行经皮气管切开术。经皮套件的成本和支气管镜的使用增加了成本。在适当选择的患者中,它是常规气管切开术的良好替代方法。

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