Background :
Tracheostomy is one of the most commonly performed procedures worldwide, mainly in critically ill patients requiring prolonged ventilation, facial trauma management, laryngeal fractures, or laryngeal malignancy. Transition from endotracheal intubation to tracheostomy offers several advantages including better airway care, preservation of laryngeal function, improved patient comfort, reduced need for sedatives and analgesics, earlier ventilator weaning, and potential for speech and oral intake. This ultimately reduces ICU and hospital stay, making care more cost-effective.
Methods :
This prospective observational study was conducted in the 22-bedded neuro ICU and medical ICU of Birat Medical College and Teaching Hospital. Data were collected from 1st August 2021 to 28th February 2022. All patients requiring tracheostomy for prolonged intubation, airway protection, or tracheobronchial toileting were included.
Results :
A total of 71 patients were included, with 54.9% male and 45.1% female (ratio 1.2:1). The age ranged from 18 to 82 years with a mean age of 53.25 years.
The most common indication for percutaneous dilatational tracheostomy was prolonged intubation (40.8%), followed by airway protection (38%) and pulmonary hygiene maintenance (21.1%).
Conclusion :
Percutaneous dilatational tracheostomy is a safe and effective bedside procedure for critically ill patients, offering multiple clinical benefits with minimal invasiveness.
mainly done in the critically ill patients requiring long term ventilation, facial trauma, laryngeal fractures, laryngeal malignancy, etc. Converting from endotracheal intubation to tracheostomy has many benefits in terms of maintaining the laryngeal function, feeding, safety and it is more comfortable than endotracheal intubation. Tracheostomized patients requires less analgesics and sedatives. It also helps in easier and early weaning from mechanical ventilator, possibility of speech, initiation of oral intake of medication. This all contributes to shorter ICU stay and hospital stay which becomes more cost effective. Methods: This is a prospective observational study that was conducted in the 22 bedded neuro intensive care and medical intensive care unit of Birat Medical College and Teaching Hospital. The data were collected from 1st Aug 2021 to 28th Feb 2022. All the patients needing tracheostomy for prolonged intubation, protection of airway and to maintain tracheobronchial toileting was taking under study. Results: Our study was a prospective observational regarding percutaneous dilatational tracheostomy. A total of 71 patients were included in the study. Out of which 39(54.9%) were male and 32(45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from 18-82 years with the mean age of 53.25. The most common indication of percutaneous dilatational tracheostomy was prolonged intubation and that accounted for 29(40.8%) of the patients which was followed by airway protection 27(38%) patients and to maintain the pulmonary hygiene was seen in 15 (21.1%) patients. Conclusion: Tracheostomy is among the most frequently performed procedures in critically ill patients. Percutaneous dilatational tracheostomy is a safe and feasible procedure performed at bedside with minimal invasive technique in ICU.