Tracheostomy as an Effort to Help Weaning Ventilated Obese Patient: A Case Report

Liliriawati Ananta Kahar, Diflayzer, Wiwi Monika Sari
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Abstract

Background: The prevalence of tracheostomy in the ICU was performed in 10%-15% of patients. Tracheostomy is performed in patients with prolonged intubation. The most compelling indications for tracheostomy are acute respiratory failure with prolonged or expected prolonged duration of mechanical ventilation and failure to wean from a mechanical ventilator.   Case presentation: A 60-year-old female patient came to the emergency room of Dr. M. Djamil General Hospital with decreased consciousness 2 days before admission. Vital signs showed Sopor consciousness, RR: 30 x/min, and BMI: 39 kg/m2. Thorax examination of bronchovesicular breath sounds, rhonchi +/+, wheezing +/+. The patient was intubated and put on a ventilator, and admitted to the ICU. A tracheostomy on day 5 was performed on the patient. The patient was able to be weaned from the ventilator and then admitted to the neurology ward on day 18. Conclusion: Tracheostomy can help weaning patients from mechanical ventilation. In this case, a severely obese patient can be weaned from the ventilator with a tracheostomy.
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气管切开术帮助肥胖患者脱机:1例报告
背景:ICU中气管切开术的患病率为10%-15%。气管切开术适用于长时间插管的患者。气管切开术最令人信服的适应症是急性呼吸衰竭,机械通气时间延长或预期延长,不能脱离机械呼吸机。病例介绍:一名60岁女性患者在入院前2天因意识下降来到M. Djamil总医院急诊室。生命体征为昏睡意识,RR: 30 x/min, BMI: 39 kg/m2。胸部检查支气管水疱性呼吸音,喘鸣+/+,喘鸣+/+。病人插管并戴上呼吸机,住进重症监护室。患者于第5天行气管切开术。患者能够脱离呼吸机,然后在第18天住进神经内科病房。结论:气管切开术可以帮助患者脱离机械通气。在这种情况下,严重肥胖的患者可以通过气管切开术脱离呼吸机。
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