Incidence of tracheostomy in prolonged mechanically ventilated patient in the respiratory intensive care unit

Abstract

Background Tracheostomy is considered for ill patients with respiratory failure with expected prolonged mechanical ventilation not only to facilitate pulmonary toilet, ventilator weaning but also decrease the direct laryngeal injury of endotracheal intubation. Aim The aim was to assess the incidence, indications, complications, and outcome of tracheostomy for patients with prolonged mechanical ventilation. Patients and methods A retrospective study was carried out over 10 years from January 2009 to December 2018 at the Respiratory Intensive Care Unit, El-Hussein University Hospital. This study included 120 patients who underwent open tracheostomy in the operation theater carried out by otorhinolaryngology surgeons. Complications of tracheostomy were documented. Results The age of the study group ranged from 45 to 82 years. The complications were two cases of bleeding, one case of cardiac arrest, two cases of Pneumothorax, three cases of stomal sepsis, and four cases of surgical emphysema. Laryngotracheal stenosis was observed in five patients and tubal obstruction in three patients. Conclusion Prolonged endotracheal intubation is the first main indication of tracheostomy in the respiratory ICU, although there were minimal complications from this procedure. Recommendation Early tracheostomy is recommended for patients who are expected to have prolonged tracheal intubation.