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Elective Tracheotomy Practices in Turkey.
Bulent Gucyetmez1, Hakan Korkut Atalan2, Nahit Cakar1
1Department of Anesthesiology, Acıbadem University School of Medicine, Istanbul, Turkey.
Plos One
|November 16, 2016
Summary
Elective tracheotomy in Turkey is most commonly performed for prolonged mechanical ventilation. Percutaneous techniques, particularly the Griggs guide wire dilatational forceps method, are preferred, despite risks of bleeding and stenosis.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Surgical Procedures
Background:
- Elective tracheotomy (ET) practices can vary significantly across different countries and intensive care units (ICUs).
- Understanding the epidemiology of ET procedures is crucial for standardizing care and improving patient outcomes.
Purpose of the Study:
- To investigate the epidemiology of elective tracheotomy procedures within Turkish intensive care units.
- To identify common indications, methods, and complications associated with ET in Turkey.
Main Methods:
- A nationwide survey was conducted using a 43-question email questionnaire sent to 238 ICUs recognized by the Turkish Ministry of Health.
- Data collection occurred between August 1 and August 31, 2015, with a response rate of 85.3% (203 ICUs).
Main Results:
- Prolonged mechanical ventilation (76.9%) and coma were the most frequent indications for ET.
- Percutaneous tracheotomy (PT) was the preferred method (79.8%), with the Griggs guide wire dilatational forceps (GWDF) technique being the most common (70.4%).
- Early complications included bleeding (68.0%), while late complications involved stenosis (35.0%).
Conclusions:
- Prolonged mechanical ventilation and coma are primary indications for ET in Turkish ICUs.
- Elective percutaneous tracheotomy (EPT) using the GWDF technique is the predominant procedure.
- Bronchoscopy and ultrasound guidance are infrequently utilized during EPT.