| Tracheostomy: how and when should it be done in cardiovascular surgery ICU? | |
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MedLine Citation:
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PMID: 18793218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Soner Yavas; Seyhan Yagar; Levent Mavioglu; Erdem Cetin; Hakki Zafer Iscan; Ahmet Tulga Ulus; Cemal Levent Birincioglu |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-09-10 |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 24 ISSN: 1540-8191 ISO Abbreviation: J Card Surg Publication Date: 2009 Jan-Feb |
Date Detail:
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Created Date: 2009-01-05 Completed Date: 2009-04-21 Revised Date: 2009-05-14 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 11-8 Citation Subset: IM |
Affiliation:
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Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. soneryavasmd@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiovascular Diseases
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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:
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J Card Surg. 2009 May-Jun;24(3):358
[PMID:
19438802
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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