بررسی ضرورتهای انجام تراکئوتومی و عوارض آن در بیمارستان حضرت رسول اکرم(ص) طی سالهای 79-1374

Tracheotomy is a traditional procedure described since 2000 BC. Significant decrease in upper airway obstruction caused by infection was the most common indication of tracheotomy in the past, whereas presently its primary indication is in the long-term intensive care unit patients. Although tracheotomy is often beneficial in the selected patient, it has some related complications. Increasing knowledge about indications and complications as well as their causes is helpful in selection of the proper patient and decreasing morbidity and mortality due to tracheotomy. This descriptive (existing data) study has reviewed indications and complications of this surgical procedure. A total number of 140 patients including 103 men and 37 women, who had undergone tracheotomy, were evaluated. The range of their age was between 20 days to 85 years old. Indications of tracheotomy were: prolonged intubation 32.1%, laryngeal tumors 26.4%, head and facial trauma 11.4%, subglottic stenosis 7.9%, predictable prolonged intubation period 7.9% and other indications were: thyroid tumors, tracheotomy for clearance of air way sanitation, laryngeal web, Ludwig angina, face and neck surgeries, esophageal tumors, peritonsillar abscess, laryngomalacia, miasthenia gravis and head truma. 70 patients had developed some kinds of complications. Complications of tracheotomy in this study in order of decreasing frequency were: hemorrhage, sub-cutaneous emphysema, pneumothorax, problems related to tracheotomy tube, infection, tracheal stenosis, development of granulation tissue at the site of tracheotomy, tracheoesophageal fistula, difficult decanulation, atelectasis, stenosis of tracheotomy stoma, aspiration pneumonia and pneumomediastinum. No mortality from tracheotomy was seen in this study. Indications of performing tracheotomy were similar to that of other studies but rate of complications was much higher. Key Words: 1) Tracheotomy 2) Indications 3) Complications