Resumen

TAPIA-PEREZ, Rafael et al. Percutaneous dilational tracheostomy without using a bronchoscope in the Intensive Care Unit of Carlos AlbertoSeguin-Escobedo National Hospital, Arequipa 2011-2014. Acta méd. Peru [online]. 2017, vol.34, n.1, pp.27-32. ISSN 1728-5917.

Objective: To describe the experience with percutaneous dilational tracheostomy (PDT) without using a bronchoscope in the Intensive Care Unit (ICU) of Carlos Alberto Seguin-Escobedo National Hospital, EsSalud, Arequipa. Materials and methods: This is a retrospective and descriptive study. Records of patients who underwent PDT without a bronchoscope from 2011 to 2014 were collected. Demographic variables, time of TPD completion, diagnosis at admission, comorbidities, APACHE II score, indications for tracheostomy, and complications were assessed. Results: Of 94 PDT procedures performed, 48.9% were in male subjects; the average age of patients was 60.3 ± 19.7 years; more than one third (35.1%) were brought from the Emergency Service; the APACHE II score was 18.1 ± 5.8 points. An average time of 14.6 ± 12.6 days elapsed before the procedures were performed. Most patients (97.9%) underwent a late tracheostomy. Seventeen (18.1%) patients had a previous neck ultrasonography performed; 14.9% had severe head trauma as an admission diagnosis to the ICU; the main indication for admission was neurological failure in nearly half of the patients (47.8%). Perioperative immediate non-lethal complications were: minor bleeding, stoma infection, hypotension, subcutaneous emphysema and false passage. There was one fatal complication, severe bleeding related to the procedure, and the most frequent late complication was subglottic stenosis. Finally, the overall survival rate was 71.3%. Conclusions: PDT using the Ciaglia Blue Rhino technique without bronchoscopic assistance performed at the bedside would be a safe procedure with a low incidence of severe complications

Palabras clave : Tracheostomy; dilatation.

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