Yıl: 2019 Cilt: 22 Sayı: 2 Sayfa Aralığı: 172 - 180 Metin Dili: İngilizce İndeks Tarihi: 22-05-2020

TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS

Öz:
Introduction: In intensive care units, numerous geriatric patients are mechanicallyventilated, and those with prolonged mechanical ventilation show high mortality. Suchgeriatric patients may greatly benefit from tracheotomy because it facilitates pulmonary care,increases patient comfort and helps wean them off mechanical ventilation.Materials and Method: A total of 70 mechanically ventilated geriatric patients wereinclud-ed. Patients’ electronic data, file records, age, sex, mechanical ventilation requirement,Acute Physiology and Chronic Health Evaluation II score, intubation and intensive care unit staydurations, discharge status and complications were examined.Results: The mean patient age was 78.6±7.4 years, and the mean Acute Physiology andChronic Health Evaluation II score was 27.0±5.9. Tracheotomy was performed after a meanduration of 34.8±17 days, and the mean intensive care unit stay duration was 94±54 days.Major and minor haemorrhage were observed in 1 (1.4%) and 3 (4.2%) patients, respectively.Total 53 (76%) patients died, 8 (11%) patients were discharged and 9 (13%) patients are stillhospitalized.Conclusion: The reluctance of geriatric patients’ relatives to perform tracheotomy affectsthe time of procedure and duration of intensive care unit stay.
Anahtar Kelime:

Konular: Cerrahi

YOĞUN BAKIMDA TAKİP EDİLEN GERİATRİ YAŞ GRUBU HASTALARDA TRAKEOTOMİ

Öz:
Giriş: Yoğun bakım ünitelerinde, çok sayıda geriatri hastalarının mekanik ventilasyona bağlanmaktadır. Uzun süreli mekanik ventilasyonu bağlı hastalar yüksek mortalite göstermektedir. Bu geriatri yaş grubu hastalar, trakeotomiden büyük ölçüde faydalanabilir çünkü trakeotomi akciğer bakımını kolaylaştırır, hasta konforunu arttırır ve mekanik ventilasyondan kurtulmalarına yardımcı olur. Gereç ve Yöntem: Çalışmada mekanik ventilasyona bağlı toplam 70 geriatri yaş grubunda hasta alındı. Hastaların elektronik verileri, dosya kayıtları, yaş, cinsiyet, mekanik ventilasyon gereksinimi, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II skoru, entübasyon ve yoğun bakım ünitesinde kalma süresi, taburculuk durumu ve komplikasyonları incelendi. Bulgular: Ortalama hasta yaşı 78.6±7.4 yıl ve ortalama Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II skoru 27.0±5.9 idi. Ortalama 34.8±17 gün sonra trakeotomi yapıldı ve yoğun bakımda kalış süresi ortalama 94±54 gündü. Hastaların 1’inde majör (%1.4), üçünde (%4.2) minör kanama izlendi. Toplam 53 (%76) hasta öldü, 8 (%11) hasta taburcu edildi ve 9 (%13) hasta hala hastanede kaldı. Sonuç: Geriatri yaş grubundaki hastaların yakınlarının trakeotomi yapma konusundaki isteksizliği, işlem süresini ve yoğun bakım ünitesinde kalma süresini etkilemektedir.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Mallick A, Bodenham AR. Tracheostomy in critically ill patients. Eur J Anaesthesiol 2010;27(8):676-82. (PMID:20523214).
  • 2. Baskin JZ, Panagopoulos G, Parks C, Rothstein S, Komisar A. Clinical outcomes for the elderly patient receiving a tracheotomy. Head Neck 2004;26(1):71-76. (PMID:14724909).
  • 3. Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care 2006;10(2):R55. (PMID:16606435).
  • 4. Turan G, Yildirim AR A, Kuplay YY, Abitağaoğlu S, Şanlı Karip C, Öksüz M. Weaning in geriatric patients: a retrospective clinical study. Turk J Geriatr 2017;20(4):264-70.
  • 5. Engoren M, Arslanian-Engoren C, Fenn-Buderer N. Hospital and long-term outcome after tracheostomy for respiratory failure. Chest 2004;125(1):220-27. (PMID:14718444).
  • 6. Dewar DM, Kurek CJ, Lambrinos J, Cohen IL, Zhong Y. Patterns in costs and out-comes for patients with prolonged mechanical ventilation undergoing tracheostomy: an analysis of discharges under diagnosis-related group 483 in New York State from 1992 to 1996. Crit Care Med 1999;27(12):2640-47. (PMID:10628603).
  • 7. Cader SA, de Vale RG, Castro JC, et al. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial. J Physiother 2010;56(3):171-7. (PMID:20795923).
  • 8. Lai CC, Ko SC, Chen CM, Weng SF, Tseng KL, Cheng KC. The outcomes and prog-nostic factors of the very elderly requiring prolonged mechanical ventilation in a single respiratory care centre. Medicine (Baltimore) 2016;95(2):e2479. (PMID:26765452).
  • 9. Hosokawa K, Nishimura M, Egi M, Vincent JV. Timing of tracheotomy in ICU pa-tients: a systematic review of randomized controlled trials; Critical Care 2015;19:424. (PMID:26635016).
  • 10. Turković TM, Lukić A, Perić M. Early versus late percutaneous tracheotomy in critical-ly ill patients: A retrospective single center observational study. Acta Clin Croat 2016;55(1):33-40. (PMID:27276770).
  • 11. Norton SA, Quill TE. Complex questions embedded 76. (PMID:14738090).
  • 12. Freeman BD, Borecki IB, Coopersmith CM, Buchman TG. Relationship between tracheostomy timing and duration of mechanical ventilation in critically ill patients. Crit Care Med 2005;33(11):2513-20. (PMID:16276175).
  • 13. Schneider GT, Christensen N, Doerr TD. Early tracheotomy in elderly patients results in less ventilator-associated pneumonia; Otolaryngol Head Neck Surg 2009;140(2)250-55. (PMID:19201298).
  • 14. Duran FY, Albayrak D. Percutaneous tracheostomy application to geriatric patients in an intensive care unit by anesthesiologists: an analysis of 47 cases. Cyprus J Med Sci 2016;1:1-4.
  • 15. Kollef MH, Ahrens TS, Shannon W. Clinical predictors and outcomes for patients re-quiring tracheostomy in the intensive care unit. Crit Care Med 1999;27(9):1714- 20. (PMID:10507588).
  • 16. McCormick B, Manara AR. Mortality from percutaneous dilatational tracheostomy. A report of three cases. Anaesthesia 2005;60(5):490-95. (PMID:15819770).
  • 17. Sanabria A. Which percutaneous tracheostomy method is better? A systematic review. Respir Care 2014;59(11):1660-70. (PMID:25185145 ).
  • 18. Fernandez-Bussy S, Mahajan B, Folch E, Caviedes I, Guerrero J, Majid A. Tracheostomy tube placement early and late complications. J Bronchol Intervent Pulmonol 2015;22(4):357-64. (PMID:26348694).
APA Doğu C, KAYIR S, Dogan G, EKİCİ AKDAĞLI A, ÖZÇİFTÇİ S, yağan ö (2019). TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. , 172 - 180.
Chicago Doğu Cihangir,KAYIR Selcuk,Dogan Guvenc,EKİCİ AKDAĞLI Arzu,ÖZÇİFTÇİ Serhat,yağan özgür TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. (2019): 172 - 180.
MLA Doğu Cihangir,KAYIR Selcuk,Dogan Guvenc,EKİCİ AKDAĞLI Arzu,ÖZÇİFTÇİ Serhat,yağan özgür TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. , 2019, ss.172 - 180.
AMA Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. . 2019; 172 - 180.
Vancouver Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. . 2019; 172 - 180.
IEEE Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö "TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS." , ss.172 - 180, 2019.
ISNAD Doğu, Cihangir vd. "TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS". (2019), 172-180.
APA Doğu C, KAYIR S, Dogan G, EKİCİ AKDAĞLI A, ÖZÇİFTÇİ S, yağan ö (2019). TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. Türk Geriatri Dergisi, 22(2), 172 - 180.
Chicago Doğu Cihangir,KAYIR Selcuk,Dogan Guvenc,EKİCİ AKDAĞLI Arzu,ÖZÇİFTÇİ Serhat,yağan özgür TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. Türk Geriatri Dergisi 22, no.2 (2019): 172 - 180.
MLA Doğu Cihangir,KAYIR Selcuk,Dogan Guvenc,EKİCİ AKDAĞLI Arzu,ÖZÇİFTÇİ Serhat,yağan özgür TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. Türk Geriatri Dergisi, vol.22, no.2, 2019, ss.172 - 180.
AMA Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. Türk Geriatri Dergisi. 2019; 22(2): 172 - 180.
Vancouver Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS. Türk Geriatri Dergisi. 2019; 22(2): 172 - 180.
IEEE Doğu C,KAYIR S,Dogan G,EKİCİ AKDAĞLI A,ÖZÇİFTÇİ S,yağan ö "TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS." Türk Geriatri Dergisi, 22, ss.172 - 180, 2019.
ISNAD Doğu, Cihangir vd. "TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS". Türk Geriatri Dergisi 22/2 (2019), 172-180.