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Elective bedside tracheostomy in the intensive care unit
A Upadhyay1, J Maurer, J Turner
1Department of Surgery, New York Hospital Medical Center of Queens, Flushing 11355, USA.
Journal of the American College of Surgeons
|July 1, 1996
Summary
Performing tracheostomy at the bedside in the Intensive Care Unit (ICU) is as safe as in the operating room (OR). This approach avoids patient transport risks and is a safe alternative for elective tracheostomy procedures.
Area of Science:
- Medical Procedures
- Surgical Safety
- Intensive Care Medicine
Background:
- Tracheostomy is a common procedure with a historically high complication rate.
- Concerns about transport risks have led to suggestions for operating room (OR) performance.
- Bedside tracheostomy in the Intensive Care Unit (ICU) is safe but not widely adopted.
Purpose of the Study:
- To compare the safety of elective bedside tracheostomy with OR tracheostomy.
- To evaluate complication rates between different tracheostomy locations.
- To determine if ICU tracheostomy is a viable alternative to OR procedures.
Main Methods:
- Retrospective review of consecutive tracheostomy patients over four years.
- Comparison of elective bedside tracheostomy versus OR tracheostomy safety.
- Analysis of complication rates based on procedure location.
Main Results:
- 311 bedside tracheostomies had an 8.7% complication rate; 159 OR tracheostomies had a 9.4% rate (not significant).
- 66% of elective procedures were performed at the bedside without an anesthesiologist.
- No tracheostomy-related deaths occurred, though overall hospital mortality was 59%.
Conclusions:
- Elective tracheostomy can be safely performed at the ICU bedside.
- Performing tracheostomy in the ICU eliminates patient transport hazards.
- Bedside ICU tracheostomy is a safe and effective alternative to OR procedures.