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Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience.

Abstract：

PURPOSE:To assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT). MATERIALS AND METHODS:A retrospective study of all patients who underwent elective GWB-PDT between 2009 and 2015. A joint otolaryngology-ICU team performed all GWB-PDTs. The patients were followed until decannulation, discharge or death. Complications were divided into early (within 24 h) and late, and into minor and major. RESULTS:Two hundred and fifty six patients were included in the study. The mean age was 77.7 ± 11.8 Medical history included cardiac comorbidities (42.6%) and cerebrovascular accidents (34.4%). Overall, 48 patients (18.9%) had 60 complications, of which 70% (42/60) were minor (13 early; 29 late complications). Fifteen patients (5.9%) had major complications. Eight patients had early major complications (loss of airway - two patients [0.8%], pneumothorax - two patients [0.8%], resuscitation - one patient [0.4%], and a single patient (0.4%) died within 24 h following PDT). Two additional patients (0.8%) underwent conversion to an open tracheostomy. Seven patients had late complications (airway complications in six patients [2.3%] and major bleeding in a single patient [0.4%]). Of the seven patients with late major complications, three had two major complications. Half of the complications occurred by POD 3. CONCLUSION:GWB-PDT is a feasible and safe solution for tracheostomies in general-ward ventilated patients.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Cohen O,Shnipper R,Yosef L,Stavi D,Shapira-Galitz Y,Hain M,Lahav Y,Shoffel-Havakuk H,Halperin D,Adi N

doi

10.1016/j.jcrc.2018.06.020

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

127-132

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(18)30211-9

journal_volume

47

pub_type

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