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Titolo:
Bedside tracheostomy in the intensive care unit: A prospective randomized trial comparing open surgical tracheostomy with endoscopically guided percutaneous dilational tracheotomy
Autore:
Massick, DD; Yao, SN; Powell, DM; Griesen, D; Hobgood, T; Allen, JN; Schuller, DE;
Indirizzi:
Ohio State Univ, Dept Otolaryngol, Columbus, OH 43210 USA Ohio State UnivColumbus OH USA 43210 Otolaryngol, Columbus, OH 43210 USA Ohio State Univ, Dept Med, Div Pulm & Crit Care, Columbus, OH 43210 USA Ohio State Univ Columbus OH USA 43210 & Crit Care, Columbus, OH 43210 USA
Titolo Testata:
LARYNGOSCOPE
fascicolo: 3, volume: 111, anno: 2001,
pagine: 494 - 500
SICI:
0023-852X(200103)111:3<494:BTITIC>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
DILATATIONAL TRACHEOSTOMY; AIRWAY MANAGEMENT; PREFERRED METHOD;
Keywords:
bedside tracheostomy; tracheostomy; intensive care unit;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Schuller, DE Ohio State Univ, Ctr Comprehens Canc, Arthur G James Canc Hosp, Room 519,300 W 10th Ave, Columbus, OH 43210 USA Ohio State Univ Room 519,300 W 10th Ave Columbus OH USA 43210
Citazione:
D.D. Massick et al., "Bedside tracheostomy in the intensive care unit: A prospective randomized trial comparing open surgical tracheostomy with endoscopically guided percutaneous dilational tracheotomy", LARYNGOSCOP, 111(3), 2001, pp. 494-500

Abstract

Objectives: Objectives of the study were 1) to analyze the complication incidence and resource utilization of two methods of bedside tracheostomy and2) to define selection criteria for bedside tracheostomy. Study Design: Prospective randomized trial in the setting of a tertiary care center at a university hospital. Methods: One hundred sixty-four consecutive intubated patients selected for elective tracheostomy were enrolled, One hundred patients met selection criteria for bedside tracheostomy and were randomly assigned to either open surgical tracheostomy (50) or endoscopically guided percutaneous dilational tracheotomy(50), The remaining 64 patients received opensurgical tracheostomies in the operating room. Main outcome measures were 1) perioperative and postoperative complication incidence and 2) resource utilization. Results: Patients meeting our selection criteria for bedside tracheostomy had a significantly reduced perioperative complication rate compared with those who failed to meet these criteria, and subsequently underwent tracheostomy placement in the operating room (5% vs, 20%, P less than orequal to .01). No statistically significant difference was found in the perioperative complication incidence between the two methods of bedside tracheostomy, However, percutaneous tracheostomy placement at the bedside resulted in a significant increase in postoperative complication incidence (16% vs. 2%, P <.05) and incurred an additional patient charge of $436 per bedside procedure. Conclusions: This investigation prospectively confirms the safety of bedside tracheostomy placement in properly selected patients. Complication incidence and resource utilization are defined for two methods of bedside tracheostomy, The results of this study confirm that open surgical tracheostomy represents the standard of care in bedside tracheostomy placement by providing a more secure airway at a markedly reduced patient charge. These findings will aid in the development of protocols and pathways for surgical airway management in critically ill patients to maximize cost-effective, high-quality care.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/10/20 alle ore 11:29:55