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J Investig Med ; 58(8): 977-81, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20926957

RESUMO

PURPOSE: Percutaneous dilatational tracheotomy (PDT) is a well-established procedure in intensive care medicine. Several reports confirm a low acute and long-term complication rate. However, dilatational tracheotomy is still often postponed even in patients that are under ventilator support for more than 2 weeks. We present a retrospective study analyzing the subjective long-term results after percutaneous tracheotomy performed at our medical intensive care unit between 2002 and 2008. METHODS: We used a modified method described by Ciaglia for tracheotomy. We selected 649 patients eligible for the survey among those who had received PDT between 2002 and 2008 and had been dismissed from hospital alive. RESULTS: The return rate was 38.5% with 29.8% of the questionnaires being completed by the patients; in 32 cases, relatives reported of the patients' death. No patient experienced wound infection; none needed surgical wound revision. Dysarthria was reversible in all 16 cases; 2 patients reported a persistent hoarseness that was preexisting in both cases. One patient experienced a tracheal stenosis and received a tracheal stent; one other required a permanent tracheotomy because of a nonresectable granulation tissue. The overall rate of long-term complications associated with the long-term ventilation and the PDT was 1.8%. CONCLUSIONS: Percutaneous dilatational tracheotomy is an easily performed, cost-saving method for long-term ventilated patients with a low rate of acute and long-term complications even in old and multimorbid internal medicine patients.


Assuntos
Dilatação/instrumentação , Intubação Intratraqueal/métodos , Respiração Artificial/métodos , Insuficiência Respiratória/cirurgia , Traqueotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Coleta de Dados , Feminino , Humanos , Unidades de Terapia Intensiva , Intubação Intratraqueal/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Inquéritos e Questionários , Traqueotomia/efeitos adversos , Resultado do Tratamento , Adulto Jovem
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