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Safety and feasibility of hybrid tracheostomy
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논문 기본 정보

Type
Academic journal
Author
KANG DAEUN (건양대학교) In Beom Jeong (건양대학교) Sun Jung Kwon (건양대학교) Son Ji woong (건양대학교) Ku Gwan woo (건양대학교)
Journal
대한중환자의학회 Acute and Critical Care Acute and Critical Care 제36권 제4호 KCI Accredited Journals
Published
2021.11
Pages
369 - 373 (5page)
DOI
10.4266/acc.2021.00801

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Safety and feasibility of hybrid tracheostomy
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Background Percutaneous dilatational tracheostomy (PDT) is widely used in intensive care units, but this conventional method has some disadvantages, such as requirement of a lot of equipment and experts at the site. Especially, in situations where the patient is isolated due to an infectious disease, difficulties in using the equipment may occur, and the number of exposed persons may increase. In this paper, we introduce hybrid tracheostomy that combines the advantages of surgical tracheostomy and PDT and describe our experiences. Methods Data from 55 patients who received hybrid tracheostomy without bronchoscopy from January 2020 to February 2021 were collected and reviewed retrospectively. Hybrid tracheostomy was performed at the bedside by a single thoracic surgeon. The hybrid tracheostomy method was as follows: after the skin was incised and the trachea was exposed, only the extent of the endotracheal tube that could not be removed was withdrawn, and then tracheostomy was performed by the Seldinger method using a PDT kit. Results The average age was 66.5 years, and the proportion of men was 69.1%. Among the patients, 21.8% were taking antiplatelet drugs and 14.5% were taking anticoagulants. The average duration of the procedure was 13.3 minutes. There was no major bleeding, and there was one case of paratracheal placement of the tracheostomy tube. Conclusions In most patients, the procedure can be safely performed without any major complications. However, patients with a short neck, a neck burn or patients who have received radiation therapy to the neck should be treated with conventional methods.
#anticoagulants #bronchoscopy #intensive care units #tracheostomy #ventilator weaning.

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References (15)

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Ciaglia P / 1985 / Elective percutaneous dilatational tracheostomy : a new simple bedside procedure; preliminary report / Chest 87:715~719 google schola Iftikhar IH / 2019 / A network comparative meta-analysis of percutaneous dilatational tracheostomies using anatomic landmarks, bronchoscopic, and ultrasound guidance versus open surgical tracheostomy / Lung 197:267~275 google schola Barba CA / 1995 / Bronchoscopic guidance makes percutaneous tracheostomy a safe, cost-effective, and easy-to-teach procedure / Surgery 118:879~883 google schola Klotz R / 2018 / Percutaneous versus surgical strategy for tracheostomy : a systematic review and meta-analysis of perioperative and postoperative complications / Langenbecks Arch Surg 403:137~149 google schola Angel LF / 2003 / Comparison of surgical and percutaneous dilational tracheostomy / Clin Chest Med 24:423~429 google schola

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