Korean J Neurotrauma.  2022 Oct;18(2):246-253. 10.13004/kjnt.2022.18.e27.

Comparison of Conventional Surgical Tracheostomy and Percutaneous Dilatational Tracheostomy in the Neurosurgical Intensive Care Unit

• Lim S
• Park H
• Lee JM
• Lee K
• Heo W

• KMID: 2538456
• DOI: http://doi.org/10.13004/kjnt.2022.18.e27

Abstract

Objective
Tracheostomy is a necessary procedure for patients admitted to the neurosurgery intensive care unit (ICU) with severe brain injury, because mechanical ventilation must be maintained for a long time following neurologic failure. The purpose of this study was to compare conventional surgical tracheostomy (CST) and percutaneous dilatational tracheostomy (PDT) performed at the bedside in critically ill neurosurgery patients requiring tracheostomy to determine which procedure has comparative advantages.
Methods
This retprospective study was conducted between January 2019 and December 2020. PDT was performed on 52 patients and CST was performed on 44 patients. The baseline characteristics, procedural characteristics, and clinical outcomes were recorded.
Results
The mean operative time in the CST group was 25.5±6.5 minutes and that in the PDT group was 15.1±2.5 minutes; the difference was statistically significant (p<0.01). Four patients in the CST group and none in the PDT group experienced bleeding requiring transfusion. However, there was no significant difference in total ICU mortality or length of hospital stay. There were no statistical differences in the individual complication categories between the 2 study groups.
Conclusion
There were fewer procedure-induced complications among patients receiving PDT than among those receiving CST. In addition, the treatment time for PDT was shorter than that for CST treatment.

Keyword

Brain injury; Tracheostomy; Neurosurgery; Intensive care unit; Retrospective study