TY - JOUR AU - Naqvi, Syed Mazhar Ali AU - Bashir, Muhammad Javed AU - Hussain, Muhammad AU - Rao, Hamna PY - 2017/02/13 Y2 - 2024/03/28 TI - PERCUTANEOUS DILATATIONAL TRACHEOSTOMY: A PROSPECTIVE ANALYSIS ABOUT THE SAFETY OF PROCEDURE AMONG ICU PATIENTS JF - Journal of Postgraduate Medical Institute JA - J Postgrad Med Inst VL - 31 IS - 1 SE - Original Article DO - UR - https://jpmi.org.pk/index.php/jpmi/article/view/1991 SP - AB - Objective: To evaluate the percutaneous dilatational tracheostomy procedure<br />safety among the critically ill Medical ICU patients.<br />Methodology: The study was descriptive and conducted in Medical ICU, Department<br />of Pulmonary and Critical Care Medicine, Services Institute of Medical<br />Sciences, Lahore, from February 2015 to May 2016. Fifty three Medical<br />ICU patients underwent tracheostomy procedure through percutaneous dilatational<br />technique using both Grigg's and Ciaglia's methods. Procedure was<br />performed at bed side using local anesthesia, sedation and systemic analgesia,<br />under bronchoscopic guidance. Patients were monitored for intraprocedural<br />and postprocedural complications like: hemorrhage, stomal infection, injury to<br />adjacent structures, arrhythmias, transient hypoxemia, transient hypotension,<br />paratracheal insertion, pneumothorax, sub-cutaneous emphysema, loss of airway,<br />accidental decannulation, tracheal ring fracture and new lung infiltrate or<br />atelectasis.<br />Results: A total of 53 procedures were performed. Intraprocedural complications<br />included: Transient hypoxemia 4/53 (7.5%) &amp; hypotension 3/53 (5.6%),<br />hemorrhage 3/53 (5.6%) &amp; one case of paratracheal placement. No procedure<br />related mortality was noted. 10 patients died during the ICU stay due to the primary<br />underlying disease and one patient died after a successful decannulation.<br />36 patients had uneventful decannulation. Six patients were directly discharged<br />from ICU.<br />Conclusion: Percutaneous dilatational tracheostomy is a safe procedure with<br />low complications rate and suitable for critically ill ICU patients. ER -