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Year : 2001  |  Volume : 3  |  Issue : 1  |  Page : 11-15

Tracheostomy in ICU patient at al adan hospital a six years retrospective study (from Jan 1st 1994 to Dec 31st 1999)

1 Department of ENT, Al Adan Hospital, Kuwait
2 Department of ENT, Al Sabah Hospital, Kuwait
3 Department of Anasthesia and ICU, Al Adan Hospital, Kuwait

Correspondence Address:
MD Hussein J Al Shammari
Al Shammari, Department of ENT AI Adan Hospital, P.O. Box 1605, 40167 Mishref
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-8491.289351

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Objective: To study the clinical data related to tracheostomy in ICU patients and the recommended methods to get its benefits with the highest margin of safety. Settings: ICU, AI Adan Hospital. State of Kuwait. Patients and methods: A retrospective study reviewing the files of the recorded trachcostomised ICU patients during a 6 years period from January 1st 1994 to December 31st 1999. The patient, ventilation and tracheostomy related data were collected and analyzed. Results: The recorded number of the trachcostomised ICU patients during the study period were 181, i.e. the ICU & population annual mean were 30.1 and 7.5/100 000 respectively and the male to female ratio was 2:1. Road traffic accidents with head injury was the commonest tracheostomy indication in young age groups specially males, while cere- brovasacular accidcnts and chronic obstructive airway disease were the commonest tracheostomy indications among the old age group patients. In comparison to the total, the number of 61-80 years age group patients constituted the highest percentage (33.5%) followed by 21-40 years age group (25.4%). This study revealed that duration of the pre-tracheosto- my endotracheal intubation is relatively short (mean 10.5 days). All tracheostomies were elective and performed under general anaesthesia where patients were in their optimal medical conditions. One hudred sixty tracheostomies were performed in the operation theater, while the remaining 20 were performed at bedside. One hundred sixty three tracheostomies were performed by the classic surgical technique while the remaining 18 were performed by percutaneous dilatation technique. The all over tracheostomy related complications incidence was 12.5%. Conclusion: Road traffic accidcnts was the commonest tracheostomy indication among patients below 40 years specially males, while ccrebrovasacular accidents and chronic obstructive airway disease were the commonest tracheostomy indications in-patients above 40 years. Although tracheostomy has many benefits but is not an absolutely safe procedure. All efforts, such as optimizing the prc-opcrativc patients condition, meticulous surgical techniques, close postoperative observation, care of tracheostomy wound, frequent cuff pressure adjustment to get its benefits with the highest margin of safety, should be made.

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