Tracheotomy in the Intensive Care Unit: Indications, Complications and Prognosis

Objective: The aim of the study was to evaluate the frequency, patient characteristics, complications and the prognosis related with our percutaneous dilatational tracheotomy (PDT) practice. Materials and Methods: Hospital electronic records and intensive care unit (ICU) data of the patients with PDT performed in our 33 bed anesthesiology ICUs were used between 2010 and 2014. Results: Percutaneous tracheotomy was performed in 442 patients who were taken to work in surgery for 29 and for 413 in the ICU. Average tracheotomy opening day was 9.96 (1-46) and overall complication frequency was found 7.0% (23 early and 8 late complication). The most frequent early complication was bleeding (2.9%). Among survivors; 61.6% were decannulated, 18.6% were discharged with home type ventilator, 13% were discharged with tracheotomy cannula at spontaneous ventilation and 6.5% patients were discharged with a small sized tracheotomy cannula for pulmonary aspiration. Conclusion: In this study, the expected results were obtained in terms of the timing of tracheotomy and the frequency of complications. End of life decisions in our country are often not implemented due to the refusal of patient relatives and legal uncertainty. The vast majority of our tracheotomized patients have inevitable mortality with intracranial pathologies. For this reason, we think that our study group had a higher ICU hospital stay and mortality, because it is necessary to apply tracheotomy due to prolongation of translargeal intubation period in patients.