Abstract

Long-term mechanical ventilation is the most common situation for which tracheostomy is indicated for patients in intensive care units (ICUs). The ideal techniques for tracheostomy have been topics of considerable debate. The new modified method of surgical tracheostomy is presented with compare of the classical surgical tracheostomy (CST) and PDT techniques.
Clinical trial with external control was providing in “Heratsi” No.1 Hospital Complex Intensive Care Unit (ICU). The study was carried out on 65 patients who underwent modified method of surgical tracheostomy by Poghosyan (Main Group) and Control Group was created collecting clinical data from medical records of 53 patients who underwent the Classical Surgical Tracheostomy (CST) (Group B), and 28 patients who underwent the Percutaneus DilatationTracheostomy (PDT) (Group C). Early and intermediate complications of each method of tracheostomy were analyzed for results interpretation. Group A (PMST) had less early complications- 1.5% (1 death because of apnoea) compare to Group B (CST) 49% (26 early complications including 2 deaths) and Group C (PDT)-25% (7 complications without death).
There was no tracheostomy related mortality in intermediate stage of post-operation care in any group. Also there was less intermediate complications rate in PMST Group compare to CST Group (1 vs. 19) and PDT Group (1 vs. 5).
In our study PMST demonstrated less intraoperative and intermediate complications in compare with CST and PDT. As an open surgical method it could be used in cases, when PDT is contraindicated, but in compare with CST it is minimal invasive, without any incision of subcutaneous soft tissues and with aesthetic results similar to PDT.

Keywords: Tracheostomy; ICU; Stroke; Percutaneus Dilatational Tracheostomy