Early and late outcome after single step dilatational tracheostomy versus the guide wire dilating forceps technique: a prospective randomized clinical trial
| Autor: | Frank J. A. van den Hoogen, Johannes G. van der Hoeven, Marieke Staatsen, B.G. Fikkers |
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| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Complications Original medicine.medical_treatment Forceps Critical Care and Intensive Care Medicine Auto-immunity transplantation and immunotherapy [N4i 4] Statistics Nonparametric law.invention Tracheostomy Postoperative Complications Randomized controlled trial law Intensive care Anesthesiology Intubation Intratracheal Perception and Action [DCN 1] Medicine Intubation Humans Prospective Studies Prospective cohort study Guide wire dilating forceps Aged Analysis of Variance business.industry Middle Aged Intensive care unit Single step tracheostomy Dilatation Surgery Pathogenesis and modulation of inflammation [N4i 1] Treatment Outcome Evaluation of complex medical interventions [NCEBP 2] Female business |
| Zdroj: | Intensive Care Medicine, 37, 1103-9 Intensive Care Medicine, 37, 7, pp. 1103-9 Intensive Care Medicine |
| ISSN: | 0342-4642 |
| DOI: | 10.1007/s00134-011-2222-4 |
| Popis: | Item does not contain fulltext PURPOSE: Percutaneous tracheostomy is frequently performed in long-term ventilated patients in the intensive care unit (ICU). Unfortunately, despite many years of experience, the optimal technique is still unknown, especially considering the occurrence of late complications. The purpose of this study was to determine which of the two most frequently used percutaneous tracheostomy techniques performs best with the emphasis on late complications. METHODS: This prospective randomized trial involved 120 patients, comparing two techniques of percutaneous tracheostomy, the guide wire dilating forceps (GWDF) and the single step dilatational tracheostomy (SSDT) technique. RESULTS: Sixty patients in each group underwent a percutaneous tracheostomy and were followed for up to 3 months after decannulation. The majority of complications in both groups were minor (58.3% in the GWDF group and 61.7% in the SSDT group). We found a trend towards more major perioperative complications in the GWDF group versus the SSDT group, 10.0 versus 1.7% (p = 0.06). One patient in the SSDT group developed a significant tracheal stenosis. However, this may also have been related to prolonged translaryngeal intubation. Results of magnetic resonance imaging (MRI) investigations showed only minor tracheal changes. Only 37.5% of patients in the GWDF group and 31.8% in the SSDT group had no complaints after their percutaneous tracheostomy. CONCLUSION: Compared with the GWDF, the SSDT shows a trend toward less major perioperative complications with a comparable long-term outcome. |
| Databáze: | OpenAIRE |
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