Comparison of Ventilator-Associated Pneumonia and Surgical Site Infection between Two Methods of Tracheostomy

Abstract

Objective. To compare the incidence of ventilator-associated pneumonia (VAP) and surgical site infection (SSI) between percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST). Methods. Data on 487 patients undergoing tracheostomy between 1st January 2014 and 30th September 2020 were reviewed. Patients were divided according to the surgical techniques. Clinical characteristics and postoperative care were compared to explore the risk factors for SSI and VAP. All tracheostomies were performed by intensivists who had completed at least ten tracheostomies. ST was performed using standard techniques. PDT was performed according to a modification technique described by Ciaglia. All procedures were performed at the bedside in the ICU. Results. Of all, 344 patients (70.6%) were men and 143 (29.4%) were women, and the mean age was 56 years (standard derivation [SD] 12 years). Two hundred and sixty-six patients (54.6%) received PDT, and 221 (45.4%) received SY. Patients in the PDT group had a significantly lower rate of SSI (3.4% vs. 8.5%, P = 0.01 ) compared with the ST group. Multivariate analysis revealed that comorbidities ( P = 0.003 ), surgical type ( P = 0.01 ), and cluster nursing ( P < 0.001 ) were independent risk factors for SSI; age ( P = 0.005 ), comorbidities ( P < 0.001 ), smoking ( P = 0.008 ), and cluster nursing ( P = 0.01 ) were independent risk factors for VAP. Conclusion. PDT significantly reduces the risk of SSI. Proper care should be administrated in patients with one or more risk factors of SSI or VAP to prevent the occurrence of complications.

Laryngeal Mask Airway Versus Endotracheal Intubation for Airway Management During Percutaneous Dilatational Tracheostomy

“…A study by Zhang et al comparing surgical tracheostomy and PDT reported no statistically significant difference between the two groups in terms of ventilator-associated pneumonia (VAP). [25] Similarly, Terragni et al reported a VAP rate of 8.3%. [26] In our study, the evaluation of bacterial growth of deep tracheal aspirate cultures, clinical findings, and the presence of pneumonia before and after the PDT procedure showed that 12.82% of patients in the LMA group and 7.69% of patients in the ETT group developed pneumonia.…”

Traqueostomía percutánea por dilatación. Artículo de revisión.

“…La TPD, tiene ventaja sobre la técnica quirúrgica abierta, ya que puede ser realizada en la cabecera del paciente en la sala de cuidados críticos, esto acelera el tiempo de realización del procedimiento y disminuye el tiempo de ventilación mecánica, también se observan menores tasas de sangrado e infecciones. La desventaja más importante, es que es un procedimiento programado, es decir no puede realizarse en situaciones de emergencia (18) (19). Las complicaciones asociadas al procedimiento se minimizan con la utilización de la guía de la fibrobroncoscopía, para visualizar de forma directa la tráquea, el paso de la guía y el proceso de dilatación hasta colocación del traqueostomo (20).…”

Retracted: Comparison of Ventilator‐Associated Pneumonia and Surgical Site Infection between Two Methods of Tracheostomy

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”