经皮气管造口术在重症监护中的应用:如何提高手术的安全性?

Iván Pérez , Camilo Pérez , María-Camila Jiménez , Oscar Leonardo Torra Barajas , Johana Rendón , Jorge-Iván Alvarado Sánchez , Bladimir Alejandro Gil Valencia
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引用次数: 0

摘要

经皮气管造口术(PT)是重症监护病房(ICU)患者的常见手术。与传统的手术技术相比,这种方法有一定的好处,比如感染率更低。然而,必须考虑其禁忌症和潜在的并发症。与任何手术一样,遵循学习曲线对于减少并发症的风险很重要。超声的使用在PT过程中提供了更大的安全性,可以识别解剖结构,增加安全穿刺的可能性,特别是在以协议方式进行时。然而,需要专门的训练来实现充分的解剖鉴定。支气管镜检查的使用并不是常规的,它的作用越来越局限于解剖结构扭曲的患者。总之,如果有足够的培训和仔细的患者选择,在ICU有经验的人员执行PT是一种安全的技术。因此,其实践应成为重症监护和重症监护医学培训课程的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traqueostomía percutánea en cuidado intensivo: ¿cómo mejorar la seguridad del procedimiento?
Percutaneous tracheostomy (PT) is a common procedure in intensive care unit (ICU) patients. This method offers certain benefits compared to the traditional surgical technique, such as a lower infection rate. However, it is essential to consider its contraindications and potential complications. As with any procedure, following a learning curve is important to reduce the risk of complications.
The use of ultrasound provides greater safety during PT by allowing the identification of anatomical structures and increasing the likelihood of a safe puncture, especially when performed in a protocolized manner. However, specific training is required to achieve adequate anatomical identification. The use of bronchoscopy is not routine and its role has become increasingly limited to patients with distorted anatomies.
In summary, PT is a safe technique when performed by experienced personnel in the ICU, provided that there is adequate training and careful patient selection. Therefore, its practice should be part of the curriculum in critical care and intensive care medicine training programs.
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