Traqueostomía en el paciente crítico / Tracheostomy in the critical patient
Rev. Hosp. Clin. Univ. Chile
;
20(2): 148-159, 2009.
Artigo
em Espanhol
| LILACS
| ID: lil-545896
ABSTRACT
Tracheostomy has evolved from a complex surgical intervention traditionally performed in the operating room, to a bedside procedure that can be done in the Intensive Care Unit, through a percutaneous approach. Percutaneous tracheostomy has proven to be as safe as open surgical tracheostomy in critically ill patients undergoing mechanical ventilation; therefore it seems to be a more suitable approach for these patients because it avoids the need of mobilizing patients outside their units and is performed in less time. Ciaglia Blue Rhino technique is the most widespread method of percutaneous dilatational tracheostomy, and exhibits an adequate safety profile. Fiberoptic bronchoscopy assistance and preliminary cervical ultrasound examination in selected patients improve the safeness of the procedure. Currently, the available evidencestrongly suggests that achieving an early tracheostomy may shorten mechanical ventilation days and stay in the Intensive Care Unit, but a decline in ventilator-associated pneumonia incidence and overall mortality reduction remains to be proven. In hands of an experienced intensivist, relative contraindications should not be an impediment to perform a percutaneous tracheostomy, since it can be performed safely even in high risk critically ill patients. Recently completed studies and those close to be finished, will provide interesting data on this significant topic.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doenças Respiratórias
/
Traqueostomia
/
Cuidados Críticos
Limite:
Humanos
Idioma:
Espanhol
Revista:
Rev. Hosp. Clin. Univ. Chile
Assunto da revista:
Medicina
Ano de publicação:
2009
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Universidad de Chile/CL
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