[Tracheostomy in the ICU: is it worthwhile?].
OBJECTIVE
To determine the feasibility of performing tracheostomy in the intensive care unit (ICU) environment and to assess procedure-related complications and mortality.


METHODS
The medical records of the 73 patients submitted to tracheostomy in the ICU of the Federal University of São Paulo Hospital São Paulo between January and November of 2003 were evaluated retrospectively. All operations were performed by surgical residents, under the supervision of a thoracic surgeon, using the open technique standardized at the facility.


RESULTS
The mean age of the patients was 55.2 years. Of the 73 patients evaluated, 47 (64.4%) were male and 26 (35.6%) were female. The most common indication was prolonged orotracheal intubation (76.7%). There was no procedure-related mortality, and, in all patients, the procedure was successfully performed in the ICU. Early complications occurred in 2 patients (2.7%), who presented increased local bleeding, which was controlled using compression. The late complication was infection at the incision site, which occurred in 2 patients (2.7%) and was treated by applying local dressings, without further clinical repercussions.


CONCLUSIONS
Based on the results of our analysis, which are comparable to those found in the literature regarding tracheostomy performed in the operating room, we concluded that tracheostomy in the ICU is feasible and presents a low rate of complications, even when performed in critically ill patients and by surgeons in training. Therefore, in our view, it is possible to state that performing tracheostomy in the ICU is worthwhile.
Perfeito
João Aléssio Juliano
JA
Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, SP, Brasil. japerfeito.dcir@epm.br
Mata
Caio Augusto Sterse da
CA
Forte
Vicente
V
Carnaghi
Martin
M
Tamura
Nikei
N
Leão
Luiz Eduardo Villaca
LE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011361:Professional Competence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D014139:Tracheostomy / Q000009:adverse effects* / Q000401:mortality