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Titolo:
A single-center 8-year experience with percutaneous dilational tracheostomy
Autore:
Kearney, PA; Griffen, MM; Ochoa, JB; Boulanger, BR; Tseui, BJ; Mentzer, RM;
Indirizzi:
Univ Kentucky, Med Ctr, Dept Surg C223, Div Gen Surg,Sect Trauma Crit Care, Lexington, KY 40536 USA Univ Kentucky Lexington KY USA 40536 a Crit Care, Lexington, KY 40536 USA
Titolo Testata:
ANNALS OF SURGERY
fascicolo: 5, volume: 231, anno: 2000,
pagine: 701 - 706
SICI:
0003-4932(200005)231:5<701:AS8EWP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVENTIONAL SURGICAL TRACHEOSTOMY; INTENSIVE-CARE UNIT; DILATATIONAL TRACHEOSTOMY; LONG-TERM; AIRWAY MANAGEMENT; BEDSIDE PROCEDURE; INTUBATION; SAFE; INJURY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Kearney, PA Univ Kentucky, Med Ctr, Dept Surg C223, Div Gen Surg,Sect Trauma Crit Care, 800 Rose St, Lexington, KY 40536 USA Univ Kentucky 800 Rose St Lexington KY USA 40536 KY 40536 USA
Citazione:
P.A. Kearney et al., "A single-center 8-year experience with percutaneous dilational tracheostomy", ANN SURG, 231(5), 2000, pp. 701-706

Abstract

ObjectiveTo determine surgical, postoperative, and postdischarge complications associated with percutaneous dilational tracheostomy (PDT) in an 8-year experience at the University of Kentucky. Summary Background DataThere are known risks associated with the transport of critically iii patients to the operating room for elective tracheostomy, and less-than-optimalconditions may interfere with open bedside tracheostomy. PDT has been introduced as an alternative to open tracheostomy. Despite information supporting its safety and utility, the technique has been criticized because advocates had not provided sufficient information regarding complications. MethodsA prospective database was initiated on all patients who underwent PDT between September 1990 and May 1998. The database provided indication, procedure time, duration of intubation before PDT, and intraoperative and postoperative complications. Retrospective review of medical records and phone interviews provided long-term follow-up information. ResultsIn the 8-year period, 827 PDTs were performed in 824 patients. Two patients were excluded because PDT could not be completed for technical reasons. There were 519 male and 305 female patients. Mean age was 56 years. Prolonged mechanical ventilatory support was the most common indication. Mean procedure time was 15 minutes, and the average duration of intubation before PDTwas 10 days. The intraoperative complication rate was 6%, with premature extubation the most common complication. The procedure-related death rate was 0.6%. Postoperative complications were found in 5%, with bleeding the most common. With a mean follow-up of greater than 1 year, the tracheal stenosis rate was 1.6%. ConclusionsOn the basis of this large, single-center study, the authors conclude thatwhen performed by experienced surgeons, PDT is a safe and effective alternative to open surgical tracheostomy for intubated patients who require elective tracheostomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 23:22:33