SAFETY AND EFFICIENCY OF ELECTIVE TRACHEOSTOMY PERFORMED IN THE INTENSIVE-CARE UNIT

Purpose: Because transportation of a critically ill patient to the operating room can be hazardous and costly, a study was undertaken to determine the safety and efficiency of performing a tracheostomy at bedside in the intensive care unit. Materials and Methods: A 2-year retrospective study (1988 to 1990) was done of all tracheostomies performed (102) at bedside in the intensive care unit at Northwestern University Medical Center. Anesthetic, intensive care, and operative reports were evaluated for intraoperative and immediate (48 hours) postoperative anesthetic and surgical complications. Results: The investigation revealed an average anesthetic time of 41 minutes (range-20-75 minutes), and an average operative time of 29 minutes (range, 15 to 60 minutes). A perioperative morbidity rate of 5.5% included three anesthetic and three surgical complications, without mortality. Conclusions: This study confirms that tracheostomy performed in the intensive care unit can be a safe, economical, and time-efficient procedure.