TY - JOUR
T1 - Weaning of long-term mechanically-ventilated patients following video bronchoscopy-guided percutaneous dilatational tracheostomy
AU - Chiu, Chien Tung
AU - Chung, Yu Hsiu
AU - Lu, Hung I.
AU - Lin, Meng Chih
PY - 2005/12
Y1 - 2005/12
N2 - Background: This is a prospective study of peri-procedure and post-procedure complications and successful weaning of long-term mechanically-ventilated patients following video bronchoscopy-guided percutaneous dilatational tracheostomy (PDT). Methods: Video bronchoscopy guided PDT was performed for long-term mechanically-ventilated patients in a medical intensive care unit (ICU). Peri-procedure and post-procedure complications were prospectively observed and evaluated. The success of weaning and the factors affecting the outcomes of these patients after PDT were also investigated. Results: A total of 107 patients with mechanical ventilation were enrolled. The average duration of trans-laryngeal intubation was 27.8 ± 18.4 days which was longer than reported in previous studies. There were 70 men and 37 women, all of whom underwent bedside PDT at a medical ICU. The complication rates during and post-procedure were 8.4% and 14%, respectively. The most common complications were desaturation during the procedure and bleeding during the follow-up period. Only one death was procedure related (0.9%). After PDT, 50 patients (46.7%) were successfully weaned from mechanical ventilation. The rate of successful weaning (p = 0.02) increased while the days to achievement (p < 0.001) decreased with decreasing duration of trans-laryngeal intubation. Gender, age, body weight, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, duration of procedure, endotracheal tube diameter and position, and history of self-extubation were not related to successful weaning. Conclusions: PDT is a bedside procedure with relatively low complication and mortality rates when performed for patients on long-term mechanical ventilation in a medical ICU. The previous duration of trans-laryngeal intubation was an important determinant for successful weaning after PDT.
AB - Background: This is a prospective study of peri-procedure and post-procedure complications and successful weaning of long-term mechanically-ventilated patients following video bronchoscopy-guided percutaneous dilatational tracheostomy (PDT). Methods: Video bronchoscopy guided PDT was performed for long-term mechanically-ventilated patients in a medical intensive care unit (ICU). Peri-procedure and post-procedure complications were prospectively observed and evaluated. The success of weaning and the factors affecting the outcomes of these patients after PDT were also investigated. Results: A total of 107 patients with mechanical ventilation were enrolled. The average duration of trans-laryngeal intubation was 27.8 ± 18.4 days which was longer than reported in previous studies. There were 70 men and 37 women, all of whom underwent bedside PDT at a medical ICU. The complication rates during and post-procedure were 8.4% and 14%, respectively. The most common complications were desaturation during the procedure and bleeding during the follow-up period. Only one death was procedure related (0.9%). After PDT, 50 patients (46.7%) were successfully weaned from mechanical ventilation. The rate of successful weaning (p = 0.02) increased while the days to achievement (p < 0.001) decreased with decreasing duration of trans-laryngeal intubation. Gender, age, body weight, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, duration of procedure, endotracheal tube diameter and position, and history of self-extubation were not related to successful weaning. Conclusions: PDT is a bedside procedure with relatively low complication and mortality rates when performed for patients on long-term mechanical ventilation in a medical ICU. The previous duration of trans-laryngeal intubation was an important determinant for successful weaning after PDT.
KW - Long-term mechanical ventilation
KW - Percutaneous dilatational tracheostomy
KW - Successful weaning
UR - http://www.scopus.com/inward/record.url?scp=33344469026&partnerID=8YFLogxK
M3 - 文章
C2 - 16515016
AN - SCOPUS:33344469026
SN - 0255-8270
VL - 28
SP - 829
EP - 836
JO - Chang Gung Medical Journal
JF - Chang Gung Medical Journal
IS - 12
ER -