Tracheostomies Performed by Consultants - Results,
Complications
Lukáš J., Rambousek P., Valvoda J., Hroboň M.
Otorinolaryngologické oddělení VFN, Praha, přednosta doc. MUDr. M. Hroboň, CSc. |
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Summary:
The authors present a group of 120 patients where within the framework of
otolaryngological consultant services tracheostomy was not performed in an ENT department but
in units of intensive care of the General Faculty Hospital in Prague between Jan 1, 1998 and April
30, 1999. The tracheostomies were performed on account of the following basic diagnoses: 51%
medical, 23.3% neurological, 11.6% oncological, 6.6% traumatological and in 5.8% patients with
psychiatric disease, in 0.8% patients in a septic condition. The youngest patient was a 17-year-old
man and the oldest a 92-year-old woman, the mean age of the group being 58.6 years. The mean
period of endotracheal intubation was 7.3 days (1 to 17 days). In five patients urgent tracheostomy
was performed, incl. three without safeguarding the airways by endotracheal intubation. During
the 16-month investigation period 27 patients were decannulated (22.5%) and 27 patients (22.5%)
still have the tracheostomic cannula. 58 patients (48.3%) died during hospitalization due to complications of the basic disease.
A peroperative complication was aspiration of a foreign body. Early complications in four patients
included haemorrhage which called for surgical revision of the wound. In one patient a tracheooesophageal fistula was diagnosed, in six patients the wound disintegrated. Two re-tracheostomized
patients developed during the late period an anatomically and functionally significant tracheal
stenosis which in one patient called for a permanent cannula.
Key words:
tracheostomy, intensive care unit, tracheal stenosis, fibroscopy.
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