Abstract:
Objective: To assess the indications of tracheostomy among patients requiring prolonged mechanical ventilation and to
observe the relationship of the timings and outcome of tracheostomy with age and gender.
Study Design and Setting: It was a descriptive study conducted at intensive care unit (ICU) of Department of
Otorhinolaryngology at Bahawal Victoria Hospital from January 2017 to December 2018.
Methodology: Secondary data was collected with the help of charts of ICU patients in which elective tracheostomy was
done to replace orotracheal intubation for mechanical ventilation. Inclusion and exclusion criteria were designed. Clinical
record was reviewed for the assessment of indications of the procedure (medical or surgical) along with age and gender
distribution. The timing of tracheostomy in these patients with its outcome in terms of decannulation and weaning were
recorded. Proforma was used to enter the findings. Finally results were obtained and assessed on SPSS Version 23.
Results: Out of total 551 tracheostomies 42(7.6%) were indicated for the patients of ICU requiring prolonged mechanical
ventilation. From the 42 mechanical ventilated patients majority had Guillain-Barre syndrome (GBS) 20(47.6%). Twenty
six patients were adults (61.9%) and sixteen were children (38%).Twenty four were male patients (57.1%) and eighteen
were females (42.8%). The timing of tracheostomy among majority of the patients (40) was from 7-10 days, with mean
of 9th day with good outcome. Only two patients who underwent tracheostomy after two weeks had to face poor outcome
(failed decannulation, late weaning) (4.7%).
Conclusion: Neuroparalytic lesions were the common indication among the patients requiring prolonged mechanical
ventilation with tracheostomy. Tracheostomy if performed earlier in such patients carries good outcome.