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Titolo:
Cervical spine clearance and neck extension during percutaneous tracheostomy in trauma patients
Autore:
Mayberry, JC; Wu, IC; Goldman, RK; Chesnut, RM;
Indirizzi:
Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA Oregon Hlth Sci Univ Portland OR USA 97201 t Surg, Portland, OR 97201 USA Oregon Hlth Sci Univ, Dept Neurosurg, Portland, OR 97201 USA Oregon Hlth Sci Univ Portland OR USA 97201 rosurg, Portland, OR 97201 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 10, volume: 28, anno: 2000,
pagine: 3436 - 3440
SICI:
0090-3493(200010)28:10<3436:CSCANE>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
DILATATIONAL TRACHEOSTOMY; DILATIONAL TRACHEOSTOMY; BEDSIDE PROCEDURE; EXPERIENCE; GUIDANCE; TRIAL; SAFE;
Keywords:
cervical spine injury; percutaneous tracheostomy; head injury; trauma;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Mayberry, JC Oregon Hlth Sci Univ, Dept Surg, L223A,3181 SW Sam Jackson PkRd, Portland, OR 97201 USA Oregon Hlth Sci Univ L223A,3181 SW Sam Jackson Pk Rd Portland OR USA 97201
Citazione:
J.C. Mayberry et al., "Cervical spine clearance and neck extension during percutaneous tracheostomy in trauma patients", CRIT CARE M, 28(10), 2000, pp. 3436-3440

Abstract

Introduction: The lack of cervical spine clearance and inability to extendthe neck are assumed to be relative contraindications for percutaneous tracheostomy. Objective: To determine the necessity of cervical spine clearance and neckextension in trauma patients receiving percutaneous tracheostomy. Design: Prospective analysis of case series from August 1, 1995 to August 31, 1998. Setting: A university-based Level I trauma center. Patients: A total of 88 consecutive trauma patients receiving percutaneoustracheostomy, Patients were divided into two groups based an the radiographic or clinical status of their cervical spine: cleared and noncleared. Results: The overall success and complication rate were 99% (87/88) and 11% (10/88), respectively. There were no procedure-related deaths. The cleared group consisted of 60 patients; three patients in this group who had "bull" or "thick" necks did not have full neck extension during percutaneous tracheostomy, The noncleared group consisted of 28 patients, 13 of which had known cervical spine fractures; 27 noncleared patients were maintained in the neutral position (no extension) during percutaneous tracheostomy, whereas one patient with tow suspicion of spinal injury was partially extended, Of the 13 patients with cervical spine fractures, six patients had been stabilized with a halo or operative fixation, and seven patients were stabilized with a cervical collar at the time of percutaneous tracheostomy, The success rate was 100% (60/60) for the cleared group compared with 96% (27/28) for the noncleared group (p > .05), The complication rate was 13% (8/60) far thecleared group compared with 7.1% (2/28) for the noncleared group (p > .05), We had a 100% success rate and no complications in the seven patients with cervical spine injury who were stabilized with a cervical collar. No patient had spinal cord injury caused by percutaneous tracheostomy,Conclusion: Percutaneous tracheostomy can be safety performed in trauma patients without cervical spine clearance and neck extension, including patients with stabilized cervical spine or spinal cord injury.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/09/20 alle ore 20:36:01