Konziliárně provedené tracheostomie- výsledky, komplikace

Tracheostomies Performed by Consultants - Results,Complications

The authors present a group of 120 patients where within the framework ofotolaryngological consultant services tracheostomy was not performed in an ENT department butin units of intensive care of the General Faculty Hospital in Prague between Jan 1, 1998 and April30, 1999. The tracheostomies were performed on account of the following basic diagnoses: 51%medical, 23.3% neurological, 11.6% oncological, 6.6% traumatological and in 5.8% patients withpsychiatric disease, in 0.8% patients in a septic condition. The youngest patient was a 17-year-oldman and the oldest a 92-year-old woman, the mean age of the group being 58.6 years. The meanperiod of endotracheal intubation was 7.3 days (1 to 17 days). In five patients urgent tracheostomywas performed, incl. three without safeguarding the airways by endotracheal intubation. Duringthe 16-month investigation period 27 patients were decannulated (22.5%) and 27 patients (22.5%)still have the tracheostomic cannula. 58 patients (48.3%) died during hospitalization due to complications of the basic disease.A peroperative complication was aspiration of a foreign body. Early complications in four patientsincluded haemorrhage which called for surgical revision of the wound. In one patient a tracheooesophageal fistula was diagnosed, in six patients the wound disintegrated. Two re-tracheostomizedpatients developed during the late period an anatomically and functionally significant trachealstenosis which in one patient called for a permanent cannula.

Key words:
tracheostomy, intensive care unit, tracheal stenosis, fibroscopy.