Retrospective clinical study of tracheostomy among intubated patients of respiratory intensive care unit

Abstract

<p><strong>Background:</strong> Tracheostomy is a common surgical procedure performed in upper airway obstruction to establish alternate airway, to ease the access for secretion removal and protect lower airways and to wean in critically ill, ventilator-dependent patients. This retrospective clinical study emphasises on the indications and clinical outcome of tracheostomy procedure among intubated patients of varied clinical diagnosis in respiratory intensive care unit (RICU).</p><p><strong>Methods:</strong> This is a retrospective clinical study of intubated patients of RICU who underwent tracheostomy between Jan 2014 to Dec 2019.The case sheets of patients who fulfilled the inclusion criteria of this study and whose records were available in medical records department (MRD) of our institute for the study period were analysed for the indications for tracheostomy, timing of tracheostomy and its clinical outcome among them.</p><p><strong>Results:</strong> A total of 33 patients were included in this study and their case sheets were analysed. Most common indication for the tracheostomy was found to be prolonged intubation secondary to the chemical poisoning. The mean days of intubation before the tracheostomy was 7 days. The mean days of stay in RICU after tracheostomy among survived and dead patients was 21 and 7 days respectively which was highly significant (p=0.00).</p><p><strong>Conclusion:</strong> This retrospective study concludes that conditional survival after the tracheostomy among the previously intubated patients is found to be more after three weeks whereas the mortality is likely to be in the first week of post tracheostomy period. Hence the number of days of stay after the tracheostomy among these patients, there need not be a linear decrease in survival and should not be the reason for being despondent.</p>