Critical Care Self-Study Resources-State of the Art PDT JTD 2020

State of the Art PDT JTD 2020 - PDF

Pdf Summary

Percutaneous tracheostomy, a minimally invasive procedure performed in the intensive care unit (ICU) on patients requiring long-term ventilation, is an effective option for patients needing a tracheostomy. However, the timing of the procedure remains controversial, and there is no consensus on the optimal timing. <br /><br />Early tracheostomy has been shown to reduce the duration of mechanical ventilation, but studies have conflicting results on its impact on ventilator-associated pneumonia. It has also been associated with higher hospital mortality rates compared to late tracheostomy in some studies. <br /><br />Obesity is a common condition in ICU patients requiring tracheostomy and can increase the risk of complications during the procedure. However, other studies have shown that percutaneous tracheostomy is safe in obese patients. <br /><br />Patients with coagulation disorders or uremia may be at an increased risk of bleeding during the procedure. Proper management of anticoagulation therapy and platelet transfusions can minimize this risk. <br /><br />Post-tracheostomy care is crucial in preventing complications such as pressure ulcers. Protocols involving regular assessments, appropriate dressings, and a multidisciplinary approach have been shown to reduce the incidence of pressure ulcers. <br /><br />Overall, percutaneous tracheostomy is a safe and effective procedure when performed by experienced healthcare professionals. It is important to carefully select patients and consider factors such as obesity or coagulopathy. The use of ultrasound and bronchoscopy can help optimize the safety and accuracy of the procedure. Multidisciplinary post-tracheostomy care can further improve patient outcomes.

Keywords

Percutaneous tracheostomy

minimally invasive procedure

intensive care unit

timing of the procedure

ventilator-associated pneumonia

hospital mortality rates

obesity and tracheostomy

coagulation disorders

post-tracheostomy care

pressure ulcers