A Tracheotomy in the Intensive Care Unit

Korean Journal of Head & Neck Oncology 2002;18(1):71-75.
Published online May 30, 2002.

Kang Han Cho;Do Hyung Lim;Kyu Suk Lee;Sang Heum Paik;Hoon Shik Yang;Chun Gil Kim

중환자실에서의 기관절개술

조강한;임도형;이규석;백상흠;양훈식;김춘길

Abstract

Background and Objectives: The tracheotomy is one of the most essential surgical procedures performed in the intensive care unit (ICU). The tracheal stenosis, as a complication following endotracheal intubation or tracheotomy, has been the subject of considerable recent investigation. Many different methods have been developed to avoid the tracheal stenosis but there is still controversy about the tracheal incisions. We had performed tracheotomy using a vertical elliptical tracheal incision in the ICU to evaluate its efficiency and safety. Materials and Methods: 191 patients who underwent the tracheotomy in the ICU between 1995 and 2000 were reviewed retrospectively by chart records and interviews.
Results
The complications were reported such as bleeding, infection, subcutaneous emphysema, pneumothorax, tracheoesophageal fistula and tracheal stenosis. The total numbers of complications were 35 cases (18.3%) and the tracheal stenosis was developed in 4 patients. The characteristics of tracheal stenosis are as follows.
Conclusion
The vertical elliptical tracheal incision is the safe and reliable methods in ICU patients compared with other methods, but other factors are also important in preventing the complications.

Key Words: Tracheotomy, ICU, Tracheal stenosis