| Autor: |
Walz, M., Peitgen, K., Thürauf, N., Trost, H., Wolfhard, U., Sander, A., Ahmadi, C., Eigler, F., Walz, M K, Thürauf, N, Trost, H A, Eigler, F W |
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| Zdroj: |
Intensive Care Medicine; Jul1998, Vol. 24 Issue 7, p685-690, 6p |
| Abstrakt: |
Objective: To analyze perioperative and postoperative complications and long-term sequelae following percutaneous dilatational tracheostomy (PDT).Design: A prospective clinical study of patients undergoing PDT.Setting: Seven intensive care units at a University hospitalPatients: 326 intensive care patients (202 male, 124 female; age: 11-95 years) with indications for tracheostomy.Interventions: Using tracheoscopic guidance, 337 PDTs were performed according to Ciaglias' method. In 106 decannulated patients, tracheal narrowing was assessed by plain tracheal radiography.Results: Two procedure-related deaths were seen (0.6%). Perioperative and postoperative complications occurred with 9.5% of the PDTs. One of 106 patients, who were followed-up for at least 6 months, showed a clinically relevant tracheal stenosis. Subclinical tracheal stenosis of at least 10% of the cross-sectioned area was recognized in 46 of 106 patients (43.4%). In the univariate analysis, the degree of stenosis was influenced by the age of the patient (p = 0.044), the duration of intubation prior to PDT (p = 0.042) and by the duration of cannulation (p = 0.006). These parameters had no statistical significance in a multiple regression model.Conclusion: When performed by experienced physicians, percutaneous dilatational tracheostomy under fiberoptic guidance is a safe method. The risks of early complications and of clinically relevant tracheal stenoses are low. Subclinical tracheal stenoses are found in about 40% of patients following PDT. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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