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[1998][Open Forum] EARLY POSTOPERATIVE PERCUTANEOUS DILATATIONAL TRACHEOTOMY AFTER CARDIAC SURGERY
Rees W.,* Hubner N., Seufert K.,* Bockelmann M., Warnecke H., * Christmann U. Dept. Cardiac Surgery, * Dept. Cardiac Anesthesia Schuchtermann Klinik
Methods: From 11/95 until 12/97 69 (1, 4%) percutaneous dilatational tracheostomies were performed in a nonselected patient series of 4322 open cardiac surgery cases.
Results: Tracheotomy was performed as early as postop. day (mean. 6, range 2 - 14), when extubation was not foreseen within the next few days. Duration of intubation was 13 days (mean). In five patients we observed 6 complications (8.6 %), including, bleeding, misplacement of the tube, subcutaneous emphysema and superficial infection of the tracheostoma. Mediastinitis and wound infection of the sternal wound did not occur in a single case. Overall mortalitity was 24,6 %. No death occurred because of tracheotomy. Underlying disease was reason for the mortality. Clinically evident tracheal stenosis and unadequate granulation of the stoma were nor seen after extubation.
Conclusions: Percutaneous dilatational tracheotomy is feasible with good results and minimal risk early after cardiac surgery with midline sternotomy. Increasing incidence of mediastinitis or infection of the sternal wound was not seen. In our opinion, percutaneous dilatational tracheostomy is superior to standard surgical tracheotomy early after cardiac surgery.
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.
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