IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain

Print ISSN: 2581-5210

Online ISSN: 2581-5229

CODEN : IIJAAL

IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain (IJASHNB) open access, peer-reviewed quarterly journal publishing since 2015 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster and more...


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Kumar, Pathak, Kunwer, Gupta, Verma, and Tripathi: Emergency open tracheostomy and emergency percutaneous tracheostomy: A comperative study


Introduction

Emergency tracheostomy procedure is full of risks. Immediate complications include severe damage to the trachea, hematoma formation, subcutaneous emphysema, esophageal injury, thyroid gland or nerves injury. A collection of blood (hematoma), which may form in the neck and compress the trachea, causing breathing problems in this study we compared the complication between emergency open and percutaneous tracheostomy.

Material and Methods

In this retrospective study emergency open tracheostomy was done in 23 cases and emergency percutaneous tracheostomy was done in 52 cases. Immediate complications were compared in both these procedure.

Observation

The Table 1 shows the complications rate in emergency open and emergency percutaneous tracheostomy.

Table 1

Complications

E mergency open tracheostomy (23 cases)

Emergency percutaneous tracheostomy (52 cases)

Time taken

7 to 10 minutes

3 to 5 minutes

Severe damage to the trachea

5 (21.7%)

2(3.8%)

Hematoma formation

7 (30.4%)

1(1.9%)

Subcutaneous emphysema

3 (13%)

1(1.9%)

Esophageal injury

1 (4%)

nil

Thyroid gland injury

3 (13%)

nil

Nerves injury

2 (8.6%)

nil

Discussion

Emergency tracheostomy procedure is full of risks. In our study it is clear that emergency percutaneous tracheostomy is far better than emergency open tracheostomy and it is statistically significant. On review of literature we found that percutaneous tracheostomy is generally preferred to surgical tracheostomy (ST) in intensive care patients as it can be performed more readily on the ICU.1, 2, 3, 4, 5, 6 Kevin M. Higgins et al. study also suggested that in their meta-analysis had shown that percutaneous tracheotomies trend toward fewer overall complications than open techniques and appear to be more cost-effective by releasing operating room resources including time and personnel, provide greater feasibility in terms of bedside capability.7 Thyroid injury seems to complicate both percutaneous and surgical tracheostomy. One may be encouraged by the knowledge that in an autopsy case series many of the percutaneous attempts did in fact skewer the thyroid safely, without incurring any new haemorrhagic complications.8

Conclusion

Emergency percutaneous tracheostomy is a better option for critically ill patients in compression to the Emergency Open tracheostomy.

Source of Funding

None.

Conflict of Interest

The authors declare that there is no conflict of interest.

References

1 

B Batuwitage S Webber A Glossop Percutaneous tracheostomy Continuing Education inAnaesth Crit Care Pain201414626872

2 

Y Friedman J Fildes B Mizock J Samuel S Patel S Appavu Comparison of Percutaneous and Surgical TracheostomiesChest19961102480510.1378/chest.110.2.480

3 

P Leyn L Bedert M Delcroix P Depuydt G Lauwers Y Sokolov Tracheotomy: clinical review and guidelinesEurn J Cardio-Thorac Surg20073234122110.1016/j.ejcts.2007.05.018

4 

M Antonelli V Michetti A Plama Percutaneous translaryngeal versus surgical tracheostomy: A randomized trial with 1-yr doubleblind follow-upCrit Care Med200533101520

5 

A Delaney SM Bagshaw M Nalos Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysisCrit Care20061055

6 

HO Holdgaard J Pedersen RH Jensen KE Outzen T Midtgaard LV Johansen Percutaneous dilatational tracheostomy versus conventional surgical tracheostomyActa Anaesthesiol Scand19984255455010.1111/j.1399-6576.1998.tb05164.x

7 

The Laryngoscope Lippincott Williams & Wilkins, Inc. © 2007 The American Laryngological, Rhinological and Otological Society, Inc. Meta-Analysis Comparison of Open Versus Percutaneous Tracheostomy

8 

FJ Toye JD Weinstein Clinical Experience with Percutaneous Tracheostomy and Cricothyroidotomy in 100 PatientsJ Trauma1986261110344010.1097/00005373-198611000-00013



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Article type

Original Article


Article page

59-60


Authors Details

Shivesh Kumar, Saurabh Pathak, Rajesh Kunwer, Om Prakash Gupta, Vikas Verma*, Anuj Kumar Tripathi


Article History

Received : 15-06-2021

Accepted : 30-06-2021

Available online : 09-08-2021


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