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Related Experiment Videos

Cricothyroidotomy for prolonged ventilatory support after cardiac operations.

J V O'Connor, K Reddy, M A Ergin

    The Annals of Thoracic Surgery
    |April 1, 1985
    PubMed
    Summary

    Cricothyroidotomy is a safe and effective procedure for prolonged mechanical ventilation after cardiac surgery. This study found a low complication rate, making it the preferred choice for such patients.

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    Area of Science:

    • Cardiovascular Surgery
    • Critical Care Medicine
    • Otolaryngology

    Background:

    • Prolonged mechanical ventilation is often necessary for patients after cardiac operations.
    • Endotracheal intubation for over 7 days may necessitate alternative airway management.
    • Cricothyroidotomy is a potential surgical option for long-term airway support.

    Purpose of the Study:

    • To evaluate the safety and efficacy of cricothyroidotomy in patients requiring prolonged mechanical ventilation post-cardiac surgery.
    • To assess the complication rates associated with cricothyroidotomy in this specific patient population.
    • To determine the long-term outcomes and suitability of cricothyroidotomy as a preferred procedure.

    Main Methods:

    • A retrospective study of 49 patients who underwent cricothyroidotomy after cardiac operations and required prolonged ventilatory support.

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  • Routine use of cricothyroidotomy after approximately 7 days of endotracheal intubation.
  • Follow-up through interviews, telephone contact, or referring physician contact, including laryngoscopy and bronchoscopy for symptomatic patients.

    • Main Results:

    • No median sternotomy wound infections were observed, despite stoma colonization.
    • The only immediate complication was mild stomal bleeding in one patient on anticoagulants.
    • Nineteen patients (39%) died from underlying disease; 4 late deaths were unrelated to cricothyroidotomy.
    • Average cricothyroidotomy duration was 59 days; cannulas were removed in all survivors.
    • Complications included granulation tissue removal in one patient and tracheal resection for stenosis in two; no subglottic stenosis occurred.

    Conclusions:

    • Cricothyroidotomy demonstrates a low complication rate in patients needing prolonged mechanical ventilation post-cardiac surgery.
    • The procedure is associated with successful cannula removal and acceptable long-term outcomes.
    • Cricothyroidotomy is suggested as the procedure of choice for this patient group due to its safety profile.