Document Detail


Tracheostomy: how and when should it be done in cardiovascular surgery ICU?
MedLine Citation:
PMID:  18793218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to assess the effect of timing and techniques of tracheostomy on mortality and morbidity in cardiovascular surgery patients. METHODS: Between January 2000 and October 2007, a total of 19,559 cardiac and vascular operations were performed in our hospital, and 205 of these patients (1.04%) who underwent a tracheostomy procedure were included in this retrospective study. RESULTS: Surgical tracheostomy (ST) was employed in 134 (65.4%) and percutaneous tracheostomy (PT) in 71 (34.6%) of the cases. There were 17 complications related to all tracheostomy procedures in 15 (7.3%) patients. Bleeding, requiring surgical intervention, occurred in five (3.7%) ST patients and in one (1.4%) PT patient. Cardiac arrest related to the procedure occurred in two (1.5%) ST patients. Pneumothorax occurred in three (2.2%) ST patients and in one (1.4%) PT patient, subcutaneous emphysema in three (2.2%) ST patients and in one (1.4%) PT patient, and tracheoesophageal fistula in one (0.7%) ST patient (p>0.05). The postoperative infection rate was significantly lower, and cooperation of the patients, postoperative patient mobilization, and oral feeding rates were higher in the early tracheostomy group. The multifactorial mortality rates of early (<seven days) and late tracheostomies were 71.4% and 88.1%, respectively (p=0.037). CONCLUSIONS: We believe that both techniques can be performed safely in the ICUs. Although the need of tracheostomy is one of the foremost causes of mortality and morbidity in cardiovascular surgery patients, an early application of the procedure may have favorable effects on the expected mortality and overall infection rates of the critically ill patients.
Authors:
Soner Yavas; Seyhan Yagar; Levent Mavioglu; Erdem Cetin; Hakki Zafer Iscan; Ahmet Tulga Ulus; Cemal Levent Birincioglu
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-10
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  24     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-21     Revised Date:  2009-05-14    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-8     Citation Subset:  IM    
Affiliation:
Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. soneryavasmd@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / epidemiology,  surgery*
Cardiovascular Surgical Procedures / methods*
Female
Humans
Intensive Care Units / statistics & numerical data*
Intraoperative Complications / epidemiology*,  etiology
Male
Middle Aged
Morbidity / trends
Postoperative Complications / epidemiology*,  etiology
Prognosis
Retrospective Studies
Risk Factors
Survival Rate / trends
Time Factors
Tracheostomy / adverse effects,  methods*
Turkey / epidemiology
Comments/Corrections
Comment In:
J Card Surg. 2009 May-Jun;24(3):358   [PMID:  19438802 ]

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