Evaluation of the Clinical Course in Patients Discharged with Tracheostomy
Journal Title: Turkish Journal of Intensive Care - Year 2020, Vol 18, Issue 4
Abstract
Objective: The objectives of this study are to determine the problems of patients who underwent percutaneous tracheostomy opening in intensive care and then were discharged with a tracheostomy that had either spontaneous respiration or mechanical ventilation (MV) support, and decrease the morbidity and mortality of these patients by focusing on training their caregivers about potential problems. Materials and Methods: The files of 90 patients, who were admitted to the intensive care unit (ICU) between 2017 and 2018 with a tracheostomy, were analysed. Twenty-nine patients were discharged. Patients were grouped as cerebrovascular disease (CVD), respiratory failure (RF), neuromuscular diseases and others (Alzheimer’s, Parkinson’s). Patients and their caregivers were interviewed face-to-face or by telephone to obtain information about patients. The reasons for hospitalisation, Glasgow coma scale (GCS) score, feeding patterns, MV support, life expectancy and problems at home were recorded. Results: In 29 discharged patients, 14 of them were classified as CVD, five as RF, six as neuromuscular disease (NMD) and four as other. The mortality rates of patients with high GCS values (GCS-2) from ICU were found to be lower. The fatality rate for the NMD group (0%) was found to be significantly lower than that of CVD (64.3%) and RF (80%). Seven (50%) patients developed contracture or limited joint motion. Respiratory-related problems were the most common problems that patients experienced at home, and 12 (85.7%) had intense secretions. Constipation was the most common nutritional problem and was experienced by six patients (42.9%). Conclusion: The home care of patients with a tracheostomy requires specific procedures and may lead to the development of specific complications. In this study, we determined that the respiratory problems of home care patients, particularly those involving intense secretions, plugged the tracheostomy and required the need for MV. Another important problem is that patients have limited joint motion. Thus, before discharge, patients should be trained consistently.
Authors and Affiliations
Ahmet Sari, Osman Ekinci
Keywords
Related Articles
- EP ID EP691615
- DOI 10.4274/tybd.galenos.2019.96658
- Views 122
- Downloads 0
A Different Cause of Septic Shock: Hantavirus
Hantavirus causes two different types of infection: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. The differential diagnosis is important because it can be confused with other infectious or non...
Evaluation of the Clinical Course in Patients Discharged with Tracheostomy
Objective: The objectives of this study are to determine the problems of patients who underwent percutaneous tracheostomy opening in intensive care and then were discharged with a tracheostomy that had either spontaneous...
The Effect of Central Venous Catheter Care on Infection Development: A Systematic Review
Objective: This study was carried out systematically in order to determine the effect of central venous catheter care on central venous catheter-related infection. Materials and Methods: In this systematic review, resea...
The Effect of Endotracheal Tube Cuff Pressure Control Training on Nurses’ Knowledge Level
Objective: This study was designed to investigate the effect of endotracheal tube cuff pressure training on the knowledge level of intensive care nurses. Materials and Methods: This quasi-experimental study was conducte...
Preferences and Experiences of Family Members Witnessing Cardiopulmonary Resuscitation: A Systematic Review
This systematic review aimed to examine the preferences and experiences of family members who had witnessed cardiopulmonary resuscitation. Electronic searches were performed on Cochrane, JBI, Ovid, PubMed, Scopus, and W...