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[Tracheostomy in the intensive care unit]

M J Tomey1, A Santano, D Rodríguez

  • 1Servicio de Medicina Intensiva, Hospital General Universitario, Gregorio Marrañón, Madrid.

Enfermeria Intensiva
|April 1, 1997
PubMed
Summary
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Percutaneous tracheostomy offers lower infection rates compared to surgical procedures. However, a learning curve exists for this technique, requiring careful consideration for implementation in intensive care units.

Area of Science:

  • Critical Care Medicine
  • Surgical Procedures
  • Respiratory Therapy

Context:

  • Intensive Care Unit (ICU) setting
  • Mechanical ventilation support
  • Comparison of tracheostomy techniques

Purpose:

  • Evaluate infection rates and complications of percutaneous vs. surgical tracheostomy
  • Assess the impact of a learning curve on percutaneous tracheostomy outcomes
  • Identify patient characteristics benefiting from tracheostomy

Summary:

  • 85 tracheostomies performed (45 percutaneous, 40 surgical) over 22 months.
  • Percutaneous tracheostomy showed significantly lower stoma infection rates (5 vs. 29, p < 0.001).
  • Tracheal perforation was the most serious complication; no percutaneous tracheostomies were permanent.

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Impact:

  • Percutaneous tracheostomy demonstrates a favorable safety profile regarding infections.
  • A learning curve is evident for percutaneous tracheostomy, influencing practice adoption.
  • Tracheostomy benefits patients with acute respiratory insufficiency, neurological conditions, and COPD.