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, 朱宝琦, 等. 经皮扩张气管切开术在重症加强治疗病房中的应用. 中国中西医结合急救杂志, 2008, 15(6): 377-378.
3.	郜杨, 刘洋, 唐荣, 等. 改良经皮扩张气管切开术在重症医学科危重患者中的应用研究. 中华危重病急救医学, 2014, 26(2): 106-109.
4.	丁勇, 王金峰, 李静, 等. 改良经皮扩张气管切开术在重症医学科危重患者中的应用研究. 中国急救医学, 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. 两种经皮气管切开术在重症患者中应用的观察. 中华急诊医学杂志, 2015, 24(10): 1147-1150.
8.	陈谦, 王家东. 经皮气管切开术的临床进展. 中华耳鼻咽喉头颈外科杂志, 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, 白艳, 王文娟, 等. 重症监护病房危重患者经皮扩张与传统气管切开术应用效果的比较. 中国危重病急救医学, 2013, 25(3): 179-180.
12.	池锐彬, 苏佩洁, 刘力新, 等. 气道保护下实施床旁气管切开术的临床分析. 临床急诊杂志, 2013, 14(6): 295-296.
13.	侯大鹏, 韩承河, 王婧. 等经皮扩张气管切开术并发症的回顾性分析. 中国急救医学, 2006, 26(6): 460-461.
14.	郜杨, 王洪亮, 刘洋, 等. 延迟退管在经皮扩张气管切开术中的应用: 附 172 例病例报告. 中华危重病急救医学, 2017, 29(1): 81-83.
15.	刘晓耘, 周青山. 超声引导经皮扩张气管切开术在 ICU 的应用. 南昌大学学报(医学版), 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, 朱宝琦, 等. 经皮扩张气管切开术在重症加强治疗病房中的应用. 中国中西医结合急救杂志, 2008, 15(6): 377-378.
3. 郜杨, 刘洋, 唐荣, 等. 改良经皮扩张气管切开术在重症医学科危重患者中的应用研究. 中华危重病急救医学, 2014, 26(2): 106-109.
4. 丁勇, 王金峰, 李静, 等. 改良经皮扩张气管切开术在重症医学科危重患者中的应用研究. 中国急救医学, 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. 两种经皮气管切开术在重症患者中应用的观察. 中华急诊医学杂志, 2015, 24(10): 1147-1150.
8. 陈谦, 王家东. 经皮气管切开术的临床进展. 中华耳鼻咽喉头颈外科杂志, 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, 白艳, 王文娟, 等. 重症监护病房危重患者经皮扩张与传统气管切开术应用效果的比较. 中国危重病急救医学, 2013, 25(3): 179-180.
12. 池锐彬, 苏佩洁, 刘力新, 等. 气道保护下实施床旁气管切开术的临床分析. 临床急诊杂志, 2013, 14(6): 295-296.
13. 侯大鹏, 韩承河, 王婧. 等经皮扩张气管切开术并发症的回顾性分析. 中国急救医学, 2006, 26(6): 460-461.
14. 郜杨, 王洪亮, 刘洋, 等. 延迟退管在经皮扩张气管切开术中的应用: 附 172 例病例报告. 中华危重病急救医学, 2017, 29(1): 81-83.
15. 刘晓耘, 周青山. 超声引导经皮扩张气管切开术在 ICU 的应用. 南昌大学学报(医学版), 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