Percutaneous dilatational tracheostomy: an observational study at tertiary level teaching hospital

Abstract

Introduction: Tracheostomy is the most commonly performed procedure worldwide. It is mainly done in critically ill patients requiring long-term ventilation, facial trauma, laryngeal fractures, laryngeal malignancy, etc., Converting from endotracheal intubation to tracheostomy has many benefits in terms of maintaining laryngeal function, feeding, and safety, it is more comfortable than endotracheal intubation. Tracheostomized patients require less analgesics and sedatives. It also helps in easier and early weaning from the mechanical ventilator, possibility of speech, and initiation of oral intake of medication. Percutaneous dilatational tracheostomy (PDT) is a safe and feasible procedure performed at bedside with minimal invasive technique in the intensive care unit (ICU). This all contributes to shorter ICU stay and hospital stay which becomes more cost-effective. Methods: This is a prospective observational study that was conducted in the 22-bedded neurointensive care and medical ICU of Birat Medical College and Teaching Hospital. The data were collected from August 01, 2021, to February 28, 2022. All patients needing tracheostomy for prolonged intubation, protection of airway, and to maintain tracheobronchial toileting was taking under study. Results: Our study was a prospective observational regarding PDT. A total of 71 patients were included in the study. Out of which, 39 (54.9%) were male and 32 (45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from 18 to 82 years with the mean age of 53.25 years. The most common indication of PDT was prolonged intubation and that accounted for 29 (40.8%) of the patients which was followed by airway protection in 27 (38%) patients and to maintain pulmonary hygiene was seen in 15 (21.1%) patients. Conclusion: Tracheostomy is among the most frequently performed procedures in critically ill patients. PDT is a safe and feasible procedure performed at bedside with minimal invasive techniques in ICU.