Publication:

Audit of surgical tracheostomy in ICU setting: an institutional study

Background The aim of the study was to assess the indication, timing of the procedure, immediate, early and late complication of surgical tracheostomy in intensive care unit.

Methods The study was done on patients who are in need for surgical tracheostomy in intensive care unit at MGM Healthcare hospital for a period of 4 years from the year July 2019 to June 2023. All patients were taken up for surgical tracheostomy at the operation theater under monitored anaesthetic care.  All patients were followed up for 1 year in the postoperative period.

Results This is a retrospective study, conducted in the Department of ENT, Head and Neck Surgery, A total of 78 patients were taken into study. Among them, the major indication for tracheostomy was the need for prolonged ventilation accounting for 76 patients and diaphragmatic palsy accounting for 2 patients. Early tracheostomy was done for 14 patients within 1-7 days of intubation and late tracheotomy were done for rest 64 patients between 8 to 14 days of intubation.  Early Complication like hemorrhage occurred in 7 patient, surgical emphysema in 3 patients.

Conclusion Prolonged intubation is the main indication for surgical tracheostomy, performed after 1 week of intubation.  Complications of tracheostomy can be life threatening and should be carefully monitored. Ideally, the procedure performed in operating room results in better outcomes. However, in case of acute airway compromise and emergency situations ICU settings and bed side procedures can avoid morbidity and mortality stand points in post operative period.