초록접수 현황
| 15F-261 | 포럼 발표 |
Tracheostomy after Cardiovascular Surgery: Conventional Tracheostomy Versus Percutaneous Dilatational Tracheostomy
이재홍, 김용한, 오홍철, 최재웅, 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : We compared the results of 2 types of tracheostomy, conventional versus percutaneous dilatational tracheostomy, performed in patients who underwent cardiovascular surgery.
Methods : Between January 2010 and December 2014, tracheostomies were performed in 77 patients who needed long-term ventilator support after cardiovascular surgery. Common indications for tracheostomy were prolonged intubation due to respiratory failure (n=34), pneumonia (n=21), and altered mentality including cerebrovascular accident (n=15). Clinical outcomes were compared between the patients who underwent conventional tracheostomy before June 2012 (Group C, n = 30) and percutaneous dilatational tracheostomy after June 2012 (Group P, n = 47). Mean patient age was 67.5±9.5 years.
Results : Median duration of intubation before tracheostomy was 16.5±9.7 days in group C and 13.9±7.7 days in group P, respectively (p=0.351). Procedure time for tracheostomy was significantly shorter in groups P than C (41.8±14.3 min vs 26.9±9.8 min, p<0.001). There were no significant differences in peri-procedural complications, such as bleeding, subcutaneous emphysema, and tube dislocation, between the 2 groups.
Conclusion : Percutaneous dilatational tracheostomy was performed with significantly shorter procedure time and did not increase peri-procedural complications, compared with conventional tracheostomy. Percutaneous tracheostomy is an attractive alternative method, compared with conventional tracheostomy, because it could be performed at earlier postoperative period in cardiovascular surgical patients who underwent sternotomy.
Methods : Between January 2010 and December 2014, tracheostomies were performed in 77 patients who needed long-term ventilator support after cardiovascular surgery. Common indications for tracheostomy were prolonged intubation due to respiratory failure (n=34), pneumonia (n=21), and altered mentality including cerebrovascular accident (n=15). Clinical outcomes were compared between the patients who underwent conventional tracheostomy before June 2012 (Group C, n = 30) and percutaneous dilatational tracheostomy after June 2012 (Group P, n = 47). Mean patient age was 67.5±9.5 years.
Results : Median duration of intubation before tracheostomy was 16.5±9.7 days in group C and 13.9±7.7 days in group P, respectively (p=0.351). Procedure time for tracheostomy was significantly shorter in groups P than C (41.8±14.3 min vs 26.9±9.8 min, p<0.001). There were no significant differences in peri-procedural complications, such as bleeding, subcutaneous emphysema, and tube dislocation, between the 2 groups.
Conclusion : Percutaneous dilatational tracheostomy was performed with significantly shorter procedure time and did not increase peri-procedural complications, compared with conventional tracheostomy. Percutaneous tracheostomy is an attractive alternative method, compared with conventional tracheostomy, because it could be performed at earlier postoperative period in cardiovascular surgical patients who underwent sternotomy.
책임저자: 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 이재홍, Tel: 02-2072-3698 , E-mail : holyjh85@naver.com
