Clinical experience in the management of tracheostomized patients in intensive care at Santa Clara Hospital

Experiencia clínica en el manejo de pacientes traqueostomizados en cuidado intensivo del Hospital Santa Clara

lntroduction: Tracheotomy is one of the most commonly performed surgical procedures in critical patients that require prolonged mechanical ventilation. Although it is a procedure utilized often, it has not been a tapie of much investigation in our country. 

Objective: The objective was to describe the experience in the treatment of tracheotomized patients hospitalized in the intensive care unit at Santa Clara Hospital. 

Design: An observational descriptive study. 

Material and Methods: Retrospective revision of 122 clínical histories from tracheotomized patients hospitalized in the intensive care unit, from march of 1995 to June of 2002. A record was generated which contained each patient's demographic data as well asthe variables related to indicetions, complications and evolution of the tracheotomy to be analyzed. 

Results: 122 tracheotomized patients were included with an average age of 54 ± 15 years. 87.6% of the population presented compromise of three or more organs, the lung being the most compromised (77%). Ali patients were ventilated using SIMV, PS. The global incidence of complications was found to be of 53.3% with stoma infection occupying first place and was found in 35 cases (28. 7%). The mortality rate was 23.8% (n=29). 

Conclusions: In our patients the indication for tracheotomy is different than other intensive care units, it is probably related to the pulmonary and cardiovascular dysfunction highly prevalent in our population. The implementation of percutaneous tracheotomy and a prospective evaluation of the experience is made necessary with this type of procedure.