Elective open tracheostomy for patients under prolonged mechanical ventilation—a study

Abstract

To determine the safety of elective open tracheostomy as a routine intensive care unit (ICU) procedure without any selection criteria, considering its peri- and postoperative complications. This is a descriptive study conducted in two hospitals in Davangere for a period of three years between April 2005 and March 2008. 40 patients, both male and female, of all age groups who were under mechanical ventilation in whom open tracheostomy was performed were included in the study. All patients who recovered were followed-up for two months. Complications arising during this period were recorded in the proforma. Our study consisted of 40 patients comprising 30 males and 10 females with male to female ratio of 3:1 and average age of 35 years, all undergoing open tracheostomy for prolonged mechanical ventilation. Various indications for mechanical ventilation included polytrauma, head injury, septicemia with multiorgan failure and dengue encephalitis. The complications which arised during the procedure and follow-up period included cardiac arrest, surgical emphysema, reactionary hemorrhage, pneumothorax, tracheo-cutaneous fistula, tracheo-oesophageal fistula. Elective open tracheostomy seems to be a safe and simple procedure, when performed by experienced surgeon under controlled circumstances, and should be considered as an option for mechanically ventilated patients.