Influence of different withdrawal time of trachea cannula on percutaneous dilational tracheostomy in critically ill patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 CHI Ruibin , ZHOU Huifen , GU Weiguang , YE Quanqiu , JIAN Zhigang , LIU Lixin

Department of Critical Care Medicine, Xiaolan Hospital of Southern Medical University, Zhongshan, Guangdong 528415, P. R. China;

Corresponding?author：

CHI Ruibin, Email: crb77970922@163.com

Keywords：

Critically ill patients; Pereutaneous dilative tracheostomy; Timing of withdrawing trachea cannula; Safety

DOI：

10.7507/1671-6205.201709024

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the influence of different withdrawal time of trachea cannula on percutaneous dilational tracheostomy (PDT) in critically ill patients. Methods In this study, we retrospectively analyzed the clinical data of 185 critically ill patients experienced PDT, who had been admitted to the adult mixed ICU of Xiaolan Hospital of Southern Medical University from January 2015 to July 2017. The patients were divided into an early PDT group (EPDT group) and a delayed PDT group (DPDT group) according to the timing of withdrawing trachea cannula. Operation information such as operation time, blood loss and the incidence of complications were collected and compared between the two groups. Results Between the EPDT group and the DPDT group, there were no obvious differences in operation time (minutes: 6.5±2.6 vs. 7.3±3.5), amount of blood loss (ml: 5.2±2.8 vs. 6.0±3.4) or conversion to traditional operation (1.9% vs. 2.4%) (all P>0.05). Compared with the EPDT group, the DPDT group patients experienced more fluctuation of intraoperative vital signs, used more dose of sedative and analgesic drugs, and experienced higher occurrence of aspiration (18.3%vs. 5.6%), balloon burst (13.4% vs. 2.9%), guide-wire placing difficulty (11.0% vs. 1.9%) and tracheostomy cannula placing difficulty (14.6% vs. 2.9%) (all P<0.05). There were no statistical significances in postoperative complications such as postoperative-hemorrhage, pneumothorax, pneumoderm, the posterior tracheal injury or incision infection between the two groups (allP<0.05). More patients acquired postoperative pulmonary infection in the DPDT group than the EDPD group (12.2%vs. 5.8%, P>0.05), and there was no statistical significances in mechanical ventilation time between the two groups (days: 5.5±3.0vs. 6.0±2.5, P>0.05). Conclusions The operation and complications of PDT in critically ill patients are influenced by the timing of withdrawing trachea cannula. The standard procedure of withdrawing trachea cannula preoperatively may offer better clinical operability and lower technical risk.

Citation： CHI Ruibin, ZHOU Huifen, GU Weiguang, YE Quanqiu, JIAN Zhigang, LIU Lixin. Influence of different withdrawal time of trachea cannula on percutaneous dilational tracheostomy in critically ill patients. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(3): 263-266. doi: 10.7507/1671-6205.201709024 Copy

1.	Mittendorf EA, McHenry CR, Smith CM, et al. Early and late outcome of bedside percutaneous tracheostomy in the intensive care unit. Am Surg, 2002, 68(4): 342-346.
2.	金雨虹, 徐赤裔, 朱寶琦, 等. 經皮擴張氣管切開術在重癥加強治療病房中的應用. 中國中西醫結合急救雜志, 2008, 15(6): 377-378.
3.	郜楊, 劉洋, 唐榮, 等. 改良經皮擴張氣管切開術在重癥醫學科危重患者中的應用研究. 中華危重病急救醫學, 2014, 26(2): 106-109.
4.	丁勇, 王金峰, 李靜, 等. 改良經皮擴張氣管切開術在重癥醫學科危重患者中的應用研究. 中國急救醫學, 2015, 35(s2): 2-4.
5.	Matsumoto H, Ohnishi M, Wakai A, et al. Safe tracheostomy: blunt puncture and dilation after minimal surgical exposure of the trachea (BPAD tracheostomy). Clin Case Rep, 2015, 3(10): 773-776.
6.	Gfiggs WM, Worthley LI, Gilligan JE, et al. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet, 1990, 170(6): 543-545.
7.	尹燕燕, 姜利, 席修明. 兩種經皮氣管切開術在重癥患者中應用的觀察. 中華急診醫學雜志, 2015, 24(10): 1147-1150.
8.	陳謙, 王家東. 經皮氣管切開術的臨床進展. 中華耳鼻咽喉頭頸外科雜志, 2010, 45(4): 342-345.
9.	Hsia DW, Ghori UK, Musani AI. Percutaneous dilational tracheostomy. Clin Chest Med, 2013, 34(3): 515-526.
10.	Freeman BD, Morris PE. Tracheostomy practice in adults with acute respiratory failure . Crit Care Med, 2012, 40(10): 2890-2896.
11.	亢宏山, 白艷, 王文娟, 等. 重癥監護病房危重患者經皮擴張與傳統氣管切開術應用效果的比較. 中國危重病急救醫學, 2013, 25(3): 179-180.
12.	池銳彬, 蘇佩潔, 劉力新, 等. 氣道保護下實施床旁氣管切開術的臨床分析. 臨床急診雜志, 2013, 14(6): 295-296.
13.	侯大鵬, 韓承河, 王婧. 等經皮擴張氣管切開術并發癥的回顧性分析. 中國急救醫學, 2006, 26(6): 460-461.
14.	郜楊, 王洪亮, 劉洋, 等. 延遲退管在經皮擴張氣管切開術中的應用: 附 172 例病例報告. 中華危重病急救醫學, 2017, 29(1): 81-83.
15.	劉曉耘, 周青山. 超聲引導經皮擴張氣管切開術在 ICU 的應用. 南昌大學學報(醫學版), 2016, 56(6): 63-66, 69.
16.	Rajajee V, Fletcher JJ, Rochlen LR, et al. Real-time ultrasound guided percutaneous dilatational tracheostomy: a feasibility study. Critical Care, 2011, 15(1): R67.
17.	Maddali M, Pratap M, Fahr J, et al. Percntaneous tracheostomy by guidewire dilating forceps technique: is bronchoscopic guidance mandatory?. Middle East J Anesthesiol, 2002, 16(5): 509-519.

1. Mittendorf EA, McHenry CR, Smith CM, et al. Early and late outcome of bedside percutaneous tracheostomy in the intensive care unit. Am Surg, 2002, 68(4): 342-346.
2. 金雨虹, 徐赤裔, 朱寶琦, 等. 經皮擴張氣管切開術在重癥加強治療病房中的應用. 中國中西醫結合急救雜志, 2008, 15(6): 377-378.
3. 郜楊, 劉洋, 唐榮, 等. 改良經皮擴張氣管切開術在重癥醫學科危重患者中的應用研究. 中華危重病急救醫學, 2014, 26(2): 106-109.
4. 丁勇, 王金峰, 李靜, 等. 改良經皮擴張氣管切開術在重癥醫學科危重患者中的應用研究. 中國急救醫學, 2015, 35(s2): 2-4.
5. Matsumoto H, Ohnishi M, Wakai A, et al. Safe tracheostomy: blunt puncture and dilation after minimal surgical exposure of the trachea (BPAD tracheostomy). Clin Case Rep, 2015, 3(10): 773-776.
6. Gfiggs WM, Worthley LI, Gilligan JE, et al. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet, 1990, 170(6): 543-545.
7. 尹燕燕, 姜利, 席修明. 兩種經皮氣管切開術在重癥患者中應用的觀察. 中華急診醫學雜志, 2015, 24(10): 1147-1150.
8. 陳謙, 王家東. 經皮氣管切開術的臨床進展. 中華耳鼻咽喉頭頸外科雜志, 2010, 45(4): 342-345.
9. Hsia DW, Ghori UK, Musani AI. Percutaneous dilational tracheostomy. Clin Chest Med, 2013, 34(3): 515-526.
10. Freeman BD, Morris PE. Tracheostomy practice in adults with acute respiratory failure . Crit Care Med, 2012, 40(10): 2890-2896.
11. 亢宏山, 白艷, 王文娟, 等. 重癥監護病房危重患者經皮擴張與傳統氣管切開術應用效果的比較. 中國危重病急救醫學, 2013, 25(3): 179-180.
12. 池銳彬, 蘇佩潔, 劉力新, 等. 氣道保護下實施床旁氣管切開術的臨床分析. 臨床急診雜志, 2013, 14(6): 295-296.
13. 侯大鵬, 韓承河, 王婧. 等經皮擴張氣管切開術并發癥的回顧性分析. 中國急救醫學, 2006, 26(6): 460-461.
14. 郜楊, 王洪亮, 劉洋, 等. 延遲退管在經皮擴張氣管切開術中的應用: 附 172 例病例報告. 中華危重病急救醫學, 2017, 29(1): 81-83.
15. 劉曉耘, 周青山. 超聲引導經皮擴張氣管切開術在 ICU 的應用. 南昌大學學報(醫學版), 2016, 56(6): 63-66, 69.
16. Rajajee V, Fletcher JJ, Rochlen LR, et al. Real-time ultrasound guided percutaneous dilatational tracheostomy: a feasibility study. Critical Care, 2011, 15(1): R67.
17. Maddali M, Pratap M, Fahr J, et al. Percntaneous tracheostomy by guidewire dilating forceps technique: is bronchoscopic guidance mandatory?. Middle East J Anesthesiol, 2002, 16(5): 509-519.

Chinese Journal of Respiratory and Critical Care Medicine

Influence of different withdrawal time of trachea cannula on percutaneous dilational tracheostomy in critically ill patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content