Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience

被引:4
|
作者
Cohen, Oded [1 ,2 ]
Shnipper, Ruth [2 ]
Yosef, Liron [1 ,2 ]
Stavi, Dekel [3 ,4 ]
Shapira-Galitz, Yael [1 ,2 ]
Hain, Moshe [1 ,4 ]
Lahav, Yonatan [1 ,2 ]
Shoffel-Havakuk, Hagit [4 ,5 ]
Halperin, Doron [1 ,2 ]
Adi, Nimrod [3 ,4 ]
机构
[1] Kaplan Med Ctr, Dept Otolaryngol Head & Neck Surg, Rehovot, Israel
[2] Hebrew Univ Jerusalem, Hadassah Med Sch, Jerusalem, Israel
[3] Tel Aviv Sourasky Med Ctr, Kaplan Med Ctr, Intens Care Unit, Tel Aviv, Israel
[4] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel
[5] Rabin Med Ctr, Dept Otolaryngol Head & Neck Surg, Petah Tiqwa, Israel
关键词
General wards; Percutaneous dilatational tracheostomy; Complications; Safety; Bedside; Feasibility; INTENSIVE-CARE-UNIT; DILATIONAL TRACHEOSTOMY; BRONCHOSCOPIC GUIDANCE; MEDICINE WARDS; COMPLICATIONS; TRACHEOTOMY; SAFETY; STATES;
D O I
10.1016/j.jcrc.2018.06.020
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose: To assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT). Materials and methods: A retrospective study of all patients who underwent elective GWB-PDT between 2009 and 2015. A joint otolaryngology-ICU team performed all GWB-PDTs. The patients were followed until decannulation, discharge or death. Complications were divided into early (within 24 h) and late, and into minor and major. Results: Two hundred and fifty six patients were included in the study. The mean age was 77.7 +/- 11.8 Medical history included cardiac comorbidities (42.6%) and cerebrovascular accidents (34.4%). Overall, 48 patients (18.9%) had 60 complications, of which 70% (42/60) were minor (13 early; 29 late complications). Fifteen patients (5.9%) had major complications. Eight patients had early major complications (loss of airway - two patients [0.8%], pneumothorax - two patients [0.8%], resuscitation - one patient [0.4%], and a single patient (0.4%) died within 24 h following PDT).Two additional patients (0.8%) underwent conversion to an open tracheostomy. Seven patients had late complications (airway complications in six patients [2.3%] and major bleeding in a single patient [0.4%]). Of the seven patients with late major complications, three had two major complications. Half of the complications occurred by POD 3. Conclusion: GWB-PDT is a feasible and safe solution for tracheostomies in general-ward ventilated patients. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:127 / 132
页数:6
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