Background :
Tracheostomy is one of the most commonly performed procedures worldwide. It is mainly indicated in critically ill patients requiring long-term ventilation, facial trauma, laryngeal fractures, and laryngeal malignancy. Conversion from endotracheal intubation to tracheostomy offers several benefits, including preservation of laryngeal function, improved feeding, increased patient safety, and greater comfort compared to endotracheal intubation.
Patients with tracheostomy require fewer analgesics and sedatives. It also facilitates earlier weaning from mechanical ventilation, enables speech, and allows early initiation of oral intake. These advantages contribute to reduced ICU and hospital stay, making it more cost-effective.
Methods :
This was a prospective observational study conducted in the 22-bedded neuro intensive care unit and medical intensive care unit 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, and tracheobronchial toileting were included.
Results :
A total of 71 patients were included. Among them, 39 (54.9%) were male and 32 (45.1%) were female, with a male-to-female ratio of 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 :
Tracheostomy is a frequently performed procedure in critically ill patients. Percutaneous dilatational tracheostomy is a safe and feasible bedside procedure with a minimally invasive approach in ICU settings.