Kieninger, Martin and Windorfer, Martin and Eissnert, Christoph and Zech, Nina and Bele, Sylvia and Zeman, Florian and Bruendl, Elisabeth and Graf, Bernhard and Kuenzig, Holger (2019) Impact of bedside percutaneous dilational and open surgical tracheostomy on intracranial pressure, pulmonary gas exchange, and hemodynamics in neurocritical care patients. MEDICINE, 98 (35): e17011. ISSN 0025-7974, 1536-5964
Full text not available from this repository. (Request a copy)Abstract
Aim was to compare the impact of bedside percutaneous dilational tracheostomy (PDT) and open surgical technique (ST) on intracranial pressure (ICP), pulmonary gas exchange and hemodynamics. We retrospectively analyzed data of 92 neurocritical care patients with invasive ICP monitoring during either PDT (43 patients) or ST (49 patients). Peak ICP levels were higher during PDT (22 [17-38] mm Hg vs 19 [13-27] mm Hg, P=.029). Mean oxygen saturation (SpO(2)) and end-tidal carbon dioxide partial pressure (etCO(2)) did not differ. Episodes with relevant desaturation (SpO(2)<90%) or hypercapnia (etCO(2)>50mm Hg) occurred rarely (5/49 during ST vs 3/43 during PDT for SpO(2)<90%; 2/49 during ST vs 5/43 during PDT for hypercapnia). Drops in mean arterial pressure (MAP) below 60mm Hg were seen more often during PDT (8/43 vs 2/49, P=. 026). Mean infusion rate of norepinephrine did not differ (0.52mg/h during ST vs 0.45mg/h during PDT). No fatal complications were observed. Tracheostomy can be performed as ST and PDT safely in neurocritical care patients. The impact on ICP, pulmonary gas exchange and hemodynamics remains within an unproblematic range.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DILATATIONAL TRACHEOSTOMY; METAANALYSIS; TRACHEOTOMY; EXTUBATION; critical care; hemodynamics; intracranial pressure; pulmonary gas exchange; tracheostomy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Neurochirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Apr 2020 09:05 |
| Last Modified: | 01 Apr 2020 09:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26486 |
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