Emergency Tracheostomy: Complications, Anesthetic Techniques, and Outcomes

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Otolaryngology

Background:

• Acute upper airway obstruction poses significant challenges in anesthesia.
• Emergency tracheostomy is a critical intervention for such conditions.
• Understanding perioperative complications and hemodynamic instability is crucial for patient outcomes.

Purpose of the Study:

• To report the incidence and outcomes of perioperative complications in emergency tracheostomy.
• To identify factors influencing unstable intraoperative hemodynamics.
• To provide insights for optimizing anesthetic management.

Main Methods:

• Retrospective review of 253 adult patients undergoing emergency tracheostomy (Jan 2013 - Oct 2021).
• Analysis of perioperative complications and outcomes within 24 hours and 7 days post-surgery.
• Descriptive and multivariate analyses to determine influencing factors.

Main Results:

• Over half (51.8%) of patients experienced intraoperative complications, including hypotension (30.4%) and hypertension (22.5%).
• Cardiovascular instability was the predominant complication.
• Monitored anesthesia care and pre-existing hypertension were associated with unstable hemodynamics.

Conclusions:

• Cardiovascular instability is a major concern in emergency tracheostomy.
• Monitored anesthesia care and hypertension are significant predictors of hemodynamic instability.
• Enhanced communication between surgeons and anesthesiologists is vital for anesthetic planning.