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Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital
OBJECTIVE: To evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation. METHODS: Between the years 2004 and 2014, 512 patients with indication of tracheostomy accordi...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação Brasileira de Medicina intensiva
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489779/ https://www.ncbi.nlm.nih.gov/pubmed/26340151 http://dx.doi.org/10.5935/0103-507X.20150022 |
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author | Romero, Carlos M. Cornejo, Rodrigo Tobar, Eduardo Gálvez, Ricardo Luengo, Cecilia Estuardo, Nivia Neira, Rodolfo Navarro, José Luis Abarca, Osvaldo Ruiz, Mauricio Berasaín, María Angélica Neira, Wilson Arellano, Daniel Llanos, Osvaldo |
author_facet | Romero, Carlos M. Cornejo, Rodrigo Tobar, Eduardo Gálvez, Ricardo Luengo, Cecilia Estuardo, Nivia Neira, Rodolfo Navarro, José Luis Abarca, Osvaldo Ruiz, Mauricio Berasaín, María Angélica Neira, Wilson Arellano, Daniel Llanos, Osvaldo |
author_sort | Romero, Carlos M. |
collection | PubMed |
description | OBJECTIVE: To evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation. METHODS: Between the years 2004 and 2014, 512 patients with indication of tracheostomy according to clinical criteria, were prospectively and consecutively included in our study. One-third of them were high-risk patients. Demographic variables, APACHE II score, and days on mechanical ventilation prior to percutaneous tracheostomy were recorded. The efficacy of the procedure was evaluated according to an execution success rate and based on the necessity of switching to an open surgical technique. Safety was evaluated according to post-operative and operative complication rates. RESULTS: The mean age of the group was 64 ± 18 years (203 women and 309 males). The mean APACHE II score was 21 ± 3. Patients remained an average of 11 ± 3 days on mechanical ventilation before percutaneous tracheostomy was performed. All procedures were successfully completed without the need to switch to an open surgical technique. Eighteen patients (3.5%) presented procedure complications. Five patients experienced transient desaturation, 4 presented low blood pressure related to sedation, and 9 presented minor bleeding, but none required a transfusion. No serious complications or deaths associated with the procedure were recorded. Eleven patients (2.1%) presented post-operative complications. Seven presented minor and transitory bleeding of the percutaneous tracheostomy stoma, 2 suffered displacement of the tracheostomy cannula, and 2 developed a superficial infection of the stoma. CONCLUSION: Percutaneous tracheostomy using the single-step dilation technique with fiber optic bronchoscopy assistance seems to be effective and safe in critically ill patients under mechanical ventilation when performed by experienced intensive care specialists using a standardized procedure. |
format | Online Article Text |
id | pubmed-4489779 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Associação Brasileira de Medicina intensiva |
record_format | MEDLINE/PubMed |
spelling | pubmed-44897792015-07-07 Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital Romero, Carlos M. Cornejo, Rodrigo Tobar, Eduardo Gálvez, Ricardo Luengo, Cecilia Estuardo, Nivia Neira, Rodolfo Navarro, José Luis Abarca, Osvaldo Ruiz, Mauricio Berasaín, María Angélica Neira, Wilson Arellano, Daniel Llanos, Osvaldo Rev Bras Ter Intensiva Original Article OBJECTIVE: To evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation. METHODS: Between the years 2004 and 2014, 512 patients with indication of tracheostomy according to clinical criteria, were prospectively and consecutively included in our study. One-third of them were high-risk patients. Demographic variables, APACHE II score, and days on mechanical ventilation prior to percutaneous tracheostomy were recorded. The efficacy of the procedure was evaluated according to an execution success rate and based on the necessity of switching to an open surgical technique. Safety was evaluated according to post-operative and operative complication rates. RESULTS: The mean age of the group was 64 ± 18 years (203 women and 309 males). The mean APACHE II score was 21 ± 3. Patients remained an average of 11 ± 3 days on mechanical ventilation before percutaneous tracheostomy was performed. All procedures were successfully completed without the need to switch to an open surgical technique. Eighteen patients (3.5%) presented procedure complications. Five patients experienced transient desaturation, 4 presented low blood pressure related to sedation, and 9 presented minor bleeding, but none required a transfusion. No serious complications or deaths associated with the procedure were recorded. Eleven patients (2.1%) presented post-operative complications. Seven presented minor and transitory bleeding of the percutaneous tracheostomy stoma, 2 suffered displacement of the tracheostomy cannula, and 2 developed a superficial infection of the stoma. CONCLUSION: Percutaneous tracheostomy using the single-step dilation technique with fiber optic bronchoscopy assistance seems to be effective and safe in critically ill patients under mechanical ventilation when performed by experienced intensive care specialists using a standardized procedure. Associação Brasileira de Medicina intensiva 2015 /pmc/articles/PMC4489779/ /pubmed/26340151 http://dx.doi.org/10.5935/0103-507X.20150022 Text en http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited. |
spellingShingle | Original Article Romero, Carlos M. Cornejo, Rodrigo Tobar, Eduardo Gálvez, Ricardo Luengo, Cecilia Estuardo, Nivia Neira, Rodolfo Navarro, José Luis Abarca, Osvaldo Ruiz, Mauricio Berasaín, María Angélica Neira, Wilson Arellano, Daniel Llanos, Osvaldo Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital |
title | Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
title_full | Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
title_fullStr | Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
title_full_unstemmed | Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
title_short | Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
title_sort | fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of
experience at a university hospital |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489779/ https://www.ncbi.nlm.nih.gov/pubmed/26340151 http://dx.doi.org/10.5935/0103-507X.20150022 |
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