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Int Arch Otorhinolaryngol 2017; 21(01): 33-37
DOI: 10.1055/s-0036-1584227
Original Research
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

Tracheostomy in the Intensive Care Unit: a University Hospital in a Developing Country Study

Mohammad Waheed El-Anwar
1   Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zagazig University, Zagazig, Egypt
,
Ahmad Abdel-Fattah Nofal
1   Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zagazig University, Zagazig, Egypt
,
Mohammad A. El Shawadfy
1   Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zagazig University, Zagazig, Egypt
,
Ahmed Maaty
2   Department of Anesthesia and Intensive Care Units, School of Medicine, Zagazig University, Zagazig, Egypt
,
Alaa Omar Khazbak
1   Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zagazig University, Zagazig, Egypt
› Author Affiliations
Further Information

Publication History

19 February 2016

12 April 2016

Publication Date:
26 July 2016 (online)

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Abstract

Introduction Tracheostomy is the commonest surgical procedure in intensive care units (ICUs). It not only provides stable airway and facilitates pulmonary toilet and ventilator weaning, but also decreases the direct laryngeal injury of endotracheal intubation, and improves patient comfort and daily living activity.

Objective The objective of this study is to assess the incidence, indications, timing, complications (early and late), and the outcome of tracheostomy on patients in the intensive care units (ICU) at a university hospital in a developing country.

Methods This study is an observational prospective study. It was performed at the otolaryngology department and ICU new surgery hospital on 124 ICU admitted patients. We collected patients' demographic records, cause of admission, indications of tracheostomy, mechanical ventilation, and duration of ICU stay. We also gathered patientś tracheostomy records including the incidence, timing, technique, type, early and late complications, and outcome. All tracheostomized patients received follow-up for 12 months.

Results The indication for tracheostomy in ICU patients was mostly prolonged intubation (80.5%), followed by diaphragmatic paralysis (19.5%). All tracheostomies were done by the open approach technique. Tracheostomy for prolonged intubation was done within 17 to 26 days after intubation with a mean of 19.4 ± 2.07 days. Complications after tracheostomy were 13.9% tracheal stenosis and 25% subglottic stenosis.

Conclusion Prolonged endotracheal intubation is the man indication of tracheostomy, performed after two weeks of intubation. Although there were no major early complications, laryngotracheal stenosis is still a challenging sequel for tracheostomy that needs to be investigated to be prevented.

Keywords

tracheostomy - endotracheal intubation - ICU - mechanical ventilation
 

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