ABSTRACT
Objective: To evaluate the percutaneous dilatational tracheostomy procedure safety among the critically ill Medical ICU patients
Methodology: The study was descriptive and conducted in Medical ICU, Department of Pulmonary and Critical Care Medicine, Services Institute of Medical Sciences, Lahore, from February 2015 to May 2016. Fifty three Medical ICU patients underwent tracheostomy procedure through percutaneous dilatational technique using both Grigg's and Ciaglia's methods. Procedure was performed at bed side using local anesthesia, sedation and systemic analgesia, under bronchoscopic guidance. Patients were monitored for intraprocedural and postprocedural complications like: hemorrhage, stomal infection, injury to adjacent structures, arrhythmias, transient hypoxemia, transient hypotension, paratracheal insertion, pneumothorax, sub-cutaneous emphysema, loss of airway, accidental decannulation, tracheal ring fracture and new lung infiltrate or atelectasis
Results: A total of 53 procedures were performed. Intraprocedural complications included: Transient hypoxemia 4/53 [7.5%] and hypotension 3/53 [5.6%], hemorrhage 3/53 [5.6%] and one case of paratracheal placement. No procedure related mortality was noted. 10 patients died during the ICU stay due to the primary underlying disease and one patient died after a successful decannulation. 36 patients had uneventful decannulation. Six patients were directly discharged from ICU
Conclusion: Percutaneous dilatational tracheostomy is a safe procedure with low complications rate and suitable for critically ill ICU patients