Schuderer, Johannes G. and Reider, Leonie and Wunschel, Michael and Spanier, Gerrit and Spoerl, Steffen and Gottsauner, Maximilian Josef and Maurer, Michael and Meier, Johannes K. and Kummer, Peter and Reichert, Torsten E. and Ettl, Tobias (2023) Elective Tracheotomy in Patients Receiving Mandibular Reconstructions: Reduced Postoperative Ventilation Time and Lower Incidence of Hospital-Acquired Pneumonia. JOURNAL OF CLINICAL MEDICINE, 12 (3): 883. ISSN , 2077-0383
Full text not available from this repository. (Request a copy)Abstract
Elective tracheotomy (ET) secures the airway and prevents adverse airway-related events as unplanned secondary tracheotomy (UT), prolonged ventilation (PPV) or nosocomial infection. The primary objective of this study was to identify factors predisposing for airway complications after reconstructive lower ja surgery. We reviewed records of patients undergoing mandibulectomy and microvascular bone reconstruction (N = 123). Epidemiological factors, modus of tracheotomy regarding ET and UT, postoperative ventilation time and occurrence of hospital-acquired pneumonia HAP were recorded. Predictors for PPV and HAP, ET and UT were identified. A total of 82 (66.7%) patients underwent tracheotomy of which 12 (14.6%) were performed as UT. A total of 52 (42.3%) patients presented PPV, while 19 (15.4%) developed HAP. Increased operation time (OR 1.004, p = 0.005) and a difficult airway (OR 2.869, p = 0.02) were predictors, while ET reduced incidence of PPV (OR 0.054, p = 0.006). A difficult airway (OR 4.711, p = 0.03) and postoperative delirium (OR 6.761, p = 0.01) increased UT performance. HAP increased with anesthesia induction time (OR 1.268, p = 0.001) and length in ICU (OR 1.039, p = 0.009) while decreasing in ET group (HR 0.32, p = 0.02). OR for ET increased with mounting CCI (OR 1.462, p = 0.002) and preoperative radiotherapy (OR 2.8, p = 0.018). ET should be strongly considered in patients with increased CCI, preoperative radiotherapy and prolonged operation time. ET shortened postoperative ventilation time and reduced HAP.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FREE TISSUE TRANSFER; NOSOCOMIAL PNEUMONIA; AIRWAY MANAGEMENT; MICROVASCULAR RECONSTRUCTION; SCORING SYSTEM; RISK-FACTORS; NECK-CANCER; MAJOR HEAD; TRACHEOSTOMY; SURGERY; reconstructive surgery; tracheotomy; microvascular reconstruction; mandibular reconstruction; airway management; hospital acquired pneumonia |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 Mar 2024 12:58 |
| Last Modified: | 08 Mar 2024 12:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59151 |
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