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Titolo:
Early percutaneous tracheostomy after median sternotomy
Autore:
Byhahn, C; Rinne, T; Halbig, S; Albert, S; Wilke, HJ; Lischke, V; Westphal, K;
Indirizzi:
JW Goethe Univ Hosp Ctr, Dept Anesthesiol Intens Care Med & Pain Control, D-60590 Frankfurt, Germany JW Goethe Univ Hosp Ctr Frankfurt Germany D-60590 590 Frankfurt, Germany JW Goethe Univ Hosp Ctr, Dept Thorac & Cardiovasc Surg, D-60590 Frankfurt,Germany JW Goethe Univ Hosp Ctr Frankfurt Germany D-60590 0590 Frankfurt,Germany JW Goethe Univ Hosp Ctr, Dept Med Microbiol, D-60590 Frankfurt, Germany JWGoethe Univ Hosp Ctr Frankfurt Germany D-60590 590 Frankfurt, Germany
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 2, volume: 120, anno: 2000,
pagine: 329 - 334
SICI:
0022-5223(200008)120:2<329:EPTAMS>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTENSIVE-CARE UNIT; CONVENTIONAL SURGICAL TRACHEOSTOMY; DILATATIONAL TRACHEOSTOMY; ENDOTRACHEAL INTUBATION; MANAGEMENT; BEDSIDE; INJURY; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Byhahn, C JW Goethe Univ Hosp Ctr, Dept Anesthesiol Intens Care Med & PainControl, Theodor Stern Kai 7, D-60590 Frankfurt, Germany JW Goethe Univ Hosp Ctr Theodor Stern Kai 7 Frankfurt Germany D-60590
Citazione:
C. Byhahn et al., "Early percutaneous tracheostomy after median sternotomy", J THOR SURG, 120(2), 2000, pp. 329-334

Abstract

Objective: Tracheostomy offers significant advantages over endotracheal intubation in patients requiring long-term assisted ventilation. However, in patients who have undergone median sternotomy, it is believed that the danger of microbial contamination and consecutive infection of the sternal wound with microbes from the tracheostomy is high when conventional tracheostomy is performed. In contrast, percutaneous techniques an less likely to result in tracheostomy infection and thus bacterial contamination of neighboring structures. Nonetheless, to date there has been no prospective study confirming or disproving this assumption. Our study evaluated outcome after percutaneous tracheostomy in patients with a median sternotomy. Methods: A total of 144 cardiac surgical patients had elective percutaneous tracheostomy at the bedside until postoperative day 14, with 4 different techniques. Systematic microbiologic monitoring of the sternal and trachealwounds was used. Results: In 13 patients sternal wound infection was suspected, but was confirmed in only 4 (2.8%) patients who actually showed microbial contamination of the sternum. In 2 of these patients, the identified microbes were not identical to those cultured from the trachea. The other 2 patients had sternal and trachea) cultures positive for methicillin-resistant Staphylococcusaureus. Cross-contamination of the sternotomy with microbes from the patient's airways was therefore ruled out. No patient had clinical signs of tracheostomy infection. Likewise, there were no cases of mediastinitis. Conclusions: On the basis of our data, we conclude that cross-contamination of the sternal wound with microbes from the trachea is not a problem. Elective percutaneous tracheostomy is safe, even if performed during the first14 days after median sternotomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/07/20 alle ore 00:47:56