A Five Year Experience of The Tracheostomy Procedure In a Medical Intensive Care Unit

Objective: Tracheostomy formation is one of the most commonly performed surgical procedures in the intensive care unit (ICU). This study aimed to analyze tracheostomy indications, complications and survival rates, and to compare characteristics and outcomes of patients who had undergone surgical tracheostomy (ST) and percutaneous dilational tracheostomy (PDT). Methods: It was a prospective nonrandomized study conducted at a university hospital ICU. It included 88 consecutive adult patients receiving elective tracheostomy between September 2015 and February 2020. Results: The main indications for tracheostomy were prolonged mechanical ventilation, airway protection and pulmonary hygiene. The patients received a tracheostomy after a median of 17 (9-25) days of endotracheal intubation. Twenty-five percent of the patients were mobilized and 27% started oral feeding after tracheostomy. The survival rates at 28 days after tracheostomy, hospital discharge and 1 year were 64.8%, 40.9% and 15.9%, respectively. The ratio of the patients with ST was 36%. There were no differences in demographic data, comorbidity, admission diagnosis, complication rate, tracheostomy indication and survival rate between ST and PDT groups. Although duration of intubation before tracheostomy were similar between the groups, the time passed from informed consent for tracheostomy to the tracheostomy procedure was longer in the ST group (PDT, 3 [1-6]; ST, 6 [2-11] days; p=0.011). All ST patients had preoperative consultations from other clinics and the mean number of consultation per patient was 2.7. Conclusion: Both ST and PDT were safe procedures in the ICU. Since several consultations were requested, the implementation of the procedure was delayed for ST compared to PDT.