Tracheostomy Emergencies

Bontempo, Laura J.; Manning, Sara L.

doi:10.1016/j.emc.2018.09.010

Cited by 53 publications

(59 citation statements)

References 28 publications

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“…We did not encounter any significant differences in complication rates, although more patients in the tracheotomy group developed a complication, and these were commonly infections around the stoma. Bontempo and Manning report an overall complication rate of tracheotomy covering all indications to be up to 50%, but most of them were regarded as minor complications [14]. Of note, not all studies regard stoma infection as a complication [15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of intubation and tracheotomy in adult patients with acute epiglottitis or supraglottitis

Tapiovaara

Aro

Bäck

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose In acute epiglottitis (AE) or acute supraglottitis (AS), the management of the airway is crucial. We hypothesized that tracheotomized patients recover faster than intubated patients do. Methods We retrospectively reviewed all adult AE and AS patients, who underwent intubation or tracheotomy between 2007 and 2018 in a tertiary care center. Patient demographics, treatment, and complications were analyzed. Results The cohort comprised 42 patients. The airway was secured with intubation in 50% and with tracheotomy in 50%. All intubated patients (n = 21) and three tracheotomized patients were treated in the intensive care unit (p < 0.0001). Procedurerelated complications were encountered in three intubated and eight tracheotomized patients (p = 0.892). Median overall treatment cost was 11.547 € and 5.856 € in the intubated and tracheotomized patient groups, respectively (p < 0.001). The median duration of sick leave after discharge from hospital was 13 days in the tracheotomy group and 7 days in the intubation group (p = 0.097). Conclusion Tracheotomy resulted in a less expensive management in securing the airway in AE or AS, but tracheotomized patients had a trend towards more complications and longer sick leaves compared to intubated patients.

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Section: Discussionmentioning

confidence: 99%

Comparison of intubation and tracheotomy in adult patients with acute epiglottitis or supraglottitis

Tapiovaara

Aro

Bäck

et al. 2019

Eur Arch Otorhinolaryngol

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“…Complications associated with surgical tracheostomy are classified according to the time of their occurrence as (1) intraoperative (occurring within the first 24 hours), (2) early postoperative complications (occurring during the first 14 days), and (3) late postoperative complications (occurring 14 days after tracheostomy). 2,3 The complication rate varies from 5% to 40%, and the mortality rate can be as high as 2% depending on the study. 1,4 In emergency situations, the occurrence of complications is increased 2- to 5-fold.…”

mentioning

confidence: 99%

Predictors of Complications Occurrence Associated With Emergency Surgical Tracheotomy

Jotić

Milovanović

Trivić

et al. 2020

Otolaryngol.--head neck surg.

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Objective In emergency airway management, the occurrence of surgical tracheotomy complications is increased and may be fatal for the patient. However, the factors that play a role in complication occurrence and lead to lethal outcome are not known. The objective of this study was to determine predictors associated with the occurrence of complications and mortality after emergency surgical tracheostomy. Study Design Retrospective study with a systematic review of the literature. Setting Tertiary medical academic center. Subjects and Methods We included 402 adult patients who underwent emergency surgical tracheostomy under local anesthesia due to upper airway obstruction. Demographic, clinical, complication occurrence, and mortality data were collected. For statistical analysis, univariable and multivariable logistic regression methods were used. Results In multivariable analysis, significant positive predictors of complication occurrence were previously performed tracheotomy (odds ratio [OR] 3.67, 95% confidence interval [CI], 0.75–17.88), neck pathology (OR 2.05, 95% CI 1.1–1.77), and tracheotomy performed outside the operating room (OR 5.88, 95% CI, 1.58–20). General in-hospital mortality was 4%, but lethal outcome as a direct result of tracheotomy complications occurred in only 4 patients (1%) because of intraoperative and postoperative complications. Conclusion The existence of neck pathology and situations in which tracheotomy was performed outside the operating room in uncontrolled conditions were significant prognostic factors for complication occurrence. Tracheotomy-related mortality was greater in patients with intraoperative and early postoperative complications. Clinicians should be aware of the increased risk in specific cases, to prepare, prevent, or manage unwanted outcomes in further treatment and care.

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“…Tracheostomy has been one of the life saving simple procedures which can relieve the patient from the airway obstruction and helps in maintain the airway of the individual 2 . This procedure has been in practice for long time and has evolved with the development in the field of medical science 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Complications of Tracheostomy and Leading Factors Among Patients Presenting at a Tertiary Care Hospital, Karachi

Wasim

Riaz

Aslam

et al. 2021

PAFMJ

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Objective: To look for the complications of tracheostomy and factors correlated with presence of these complications at a tertiary care teaching hospital of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: ENT department, Operation Theater, Emergency department and Critical Care Unit of Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Apr to Oct 2019. Methodology: Sixty nine patients who underwent tracheostomy were included in the analysis. Final decision regarding offering the procedure of tracheostomy to the patient was made by consultant ENT specialist in liaison with the primary treating physician. Patients were assessed for the complications during the procedure, immediately after the procedure, 48 hours after the procedure and one week after the procedure. Results: Out of sixty nine patients included in the study, 8 (11.6%) patients underwent emergency tracheostomy while 61 (88.4%) underwent elective tracheostomy. Ten (14.5%) had undergone percutaneous procedure while 59 (85.5%) had undergone open surgical procedure. Hemorrhage was the commonest complication reported followed by dislodgement. With Pearson chi-square test, we found that increasing age (45 years) and emergency tracheostomy had strong association with the presence of complications among the patients undergoing tracheostomy. Conclusion: Tracheostomy emerged as a safe procedure with mostly minor self-limiting complications. Surgeon performing this procedure should be aware of these common complications and should give information care to the patients prior to the procedure. Patients who are elderly or undergoing emergency tracheostomy should be dealt with special care while doing this life saving procedure.

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Tracheostomy Emergencies

Cited by 53 publications

References 28 publications

Comparison of intubation and tracheotomy in adult patients with acute epiglottitis or supraglottitis

Comparison of intubation and tracheotomy in adult patients with acute epiglottitis or supraglottitis

Predictors of Complications Occurrence Associated With Emergency Surgical Tracheotomy

Complications of Tracheostomy and Leading Factors Among Patients Presenting at a Tertiary Care Hospital, Karachi

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