Traqueostomía percutánea con asistencia fibrobroncoscópica: una década de experiencia en un hospital universitario
AUTOR(ES)
Romero, Carlos M., Cornejo, Rodrigo, Tobar, Eduardo, Gálvez, Ricardo, Luengo, Cecilia, Estuardo, Nivia, Neira, Rodolfo, Navarro, José Luis, Abarca, Osvaldo, Ruiz, Mauricio, Berasaín, María Angélica, Neira, Wilson, Arellano, Daniel, Llanos, Osvaldo
FONTE
Rev. bras. ter. intensiva
DATA DE PUBLICAÇÃO
2015-06
RESUMO
ABSTRACT Objective: To evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation. Methods: Between the years 2004 and 2014, 512 patients with indication of tracheostomy according to clinical criteria, were prospectively and consecutively included in our study. One-third of them were high-risk patients. Demographic variables, APACHE II score, and days on mechanical ventilation prior to percutaneous tracheostomy were recorded. The efficacy of the procedure was evaluated according to an execution success rate and based on the necessity of switching to an open surgical technique. Safety was evaluated according to post-operative and operative complication rates. Results: The mean age of the group was 64 ± 18 years (203 women and 309 males). The mean APACHE II score was 21 ± 3. Patients remained an average of 11 ± 3 days on mechanical ventilation before percutaneous tracheostomy was performed. All procedures were successfully completed without the need to switch to an open surgical technique. Eighteen patients (3.5%) presented procedure complications. Five patients experienced transient desaturation, 4 presented low blood pressure related to sedation, and 9 presented minor bleeding, but none required a transfusion. No serious complications or deaths associated with the procedure were recorded. Eleven patients (2.1%) presented post-operative complications. Seven presented minor and transitory bleeding of the percutaneous tracheostomy stoma, 2 suffered displacement of the tracheostomy cannula, and 2 developed a superficial infection of the stoma. Conclusion: Percutaneous tracheostomy using the single-step dilation technique with fiber optic bronchoscopy assistance seems to be effective and safe in critically ill patients under mechanical ventilation when performed by experienced intensive care specialists using a standardized procedure.
Documentos Relacionados
- BOLSA DE ASSISTÊNCIA AO ESTUDANTE DE GRADUAÇÃO EM ENFERMAGEM COMO ATIVIDADE DE APRENDIZAGEM EM UM HOSPITAL UNIVERSITÁRIO
- Traqueostomia percutânea no doente crítico: a experiência de uma unidade de terapia intensiva clínica
- Traqueostomia percutânea no doente crítico: a experiência de uma unidade de terapia intensiva clínica
- Análisis didáctico de una lección sobre proporcionalidad en un libro de texto de primaria con herramientas del enfoque ontosemiótico
- Priorización y análisis de problemas de salud con una mirada desde la equidad: experiencia en el nivel local en Venezuela