Late Complications of Percutaneous Dilatational Tracheotomy

To assess the late complications of percutaneous dilatational tracheotomy, particularly the incidence of tracheal stenosis and voice changes. Prospective descriptive clinical study. Teaching hospital, the Netherlands. Eighty consecutive patients who were successfully decannulated after percutaneous...

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Veröffentlicht in:Chest 1996-12, Vol.110 (6), p.1572-1576
Hauptverfasser: Van Heurn, L.W. Ernest, Goei, Reginald, De Ploeg, Iwan, Ramsay, Graham, Brink, Peter R.G.
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container_end_page 1576
container_issue 6
container_start_page 1572
container_title Chest
container_volume 110
creator Van Heurn, L.W. Ernest
Goei, Reginald
De Ploeg, Iwan
Ramsay, Graham
Brink, Peter R.G.
description To assess the late complications of percutaneous dilatational tracheotomy, particularly the incidence of tracheal stenosis and voice changes. Prospective descriptive clinical study. Teaching hospital, the Netherlands. Eighty consecutive patients who were successfully decannulated after percutaneous tracheotomy. Fourteen patients died after decannulation, of tracheotomy-unrelated causes. Sixty-six patients were followed up 3 to 39 months after decannulation (mean, 16 months). Fifty-four patients underwent tomography of the trachea. In 14 patients (26%), there was tracheal narrowing of more than 10%. Data analysis showed that these stenoses were operator dependent (p=0.03). Voice changes, found in 13 (21%) of 61 patients, were major in 1 and minor in 12. Scars were generally cosmetically acceptable. Retraction of the scar, seen in 13 (19%) of 66 patients, was related to the duration of cannulation (p=0.002). A persistent tracheocutaneous fistula was present in two patients. The incidence of tracheal stenosis after percutaneous dilatational tracheotomy is low compared with conventional tracheotomy. Experience with the technique is important to avoid late complications.
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Data analysis showed that these stenoses were operator dependent (p=0.03). Voice changes, found in 13 (21%) of 61 patients, were major in 1 and minor in 12. Scars were generally cosmetically acceptable. Retraction of the scar, seen in 13 (19%) of 66 patients, was related to the duration of cannulation (p=0.002). A persistent tracheocutaneous fistula was present in two patients. The incidence of tracheal stenosis after percutaneous dilatational tracheotomy is low compared with conventional tracheotomy. 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subjects Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cicatrix - etiology
Dilatation - adverse effects
Female
Humans
Logistic Models
Male
Medical sciences
Middle Aged
PDT=percutaneous dilatational tracheotomy
percutaneous tracheostomy
percutaneous tracheotomy
Prospective Studies
Punctures
Risk Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the respiratory system
tracheal stenosis
Tracheal Stenosis - etiology
tracheocutaneous fistula
tracheostomy
Tracheotomy
Tracheotomy - adverse effects
voice changes
Voice Quality
title Late Complications of Percutaneous Dilatational Tracheotomy
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