Bedside open tracheostomy at intensive care unit-our experiences of 1000 cases at a tertiary care teaching hospital of eastern India

Abstract

IntroductionTracheostomy is usually done on critically ill patients those requiring prolonged mechanical ventilation at the intensive care unit (ICU). Bedside tracheostomy is often helpful for avoiding transferring the unstable patients to operation theater and also minimizing the cost. AimAssessing the safety, cost and procedure time, complications of bedside open tracheostomy at intensive care unit considering comparison to open tracheostomy at operation theater and bedside percutaneous dilatational tracheostomy (PDT) with its complications, cost and its simplicity. Materials and methodsThis descriptive retrospective study was carried out at a tertiary care teaching hospital during December 2006 to January 2016. It included 1000 patients, undergone open bedside tracheostomy along with 152 undergone open tracheostomy at operating room(OR) and 112 bedside PDT. All these patients were undergone bedside tracheostomy, followed up for next 3months. Complications occurring during and after tracheostomy were documented. Results and discussionThis study group comprised patients with age group of 8years to 82years. The complications among open bed side tracheostomy within 30days were 10 minor bleeding, 1 major bleeding, 2 cardiac arrest, 1 pneumothorax, 6 stomal sepsis, 5 cervical emphysema. Late complications like 2 laryngotracheal stenosis (LTS) were seen where as other complication like tracheocutaneous fistula and tracheoinominate fistula were not observed. The complications rate is less in bedside open tracheostomy than open tracheostomy at OR and bedside PDT in our study. ConclusionBedside elective open tracheostomy is safe, effective, cost effective and allowing timely tracheostomy with low morbidity.