[Percutaneous tracheotomy in developing countries: experience in the intensive care unit of the Principal Hospital in Dakar, Senegal].
The first use of percutaneous tracheotomy in intensive care was by Sheldon in 1957. Because this technique saves time, costs less, and reduces staff requirements, it is well suited to conditions in underdeveloped countries where resources are often lacking. The purpose of this prospective study conducted in intensive care unit of the Principal Military Teaching Hospital in Dakar, Senegal was to evaluate percutaneous tracheotomy in terms of effectiveness, time and resource management, and perioperative problems while trying to adapt it to resources available in a tropical intensive care setting. A total of 2958 patients were admitted during the study period including 100 who underwent percutaneous tracheotomy. Most cases involved traumatic injury. The mean implementation period was 10 days with a mean procedure time of 6 minutes. Two failures occurred requiring conversion to a surgical approach. Two patients had presented esotracheal fistula including one who died after inhalation when feeding was attempted. One patient developed stenosis. Operator experience and training were identified as good prognostic factors.
Wade
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KA
Département d'Anesthésie-Réanimation-Urgences-Hémodialyse, Hôpital Principal, Dakar, Sénégal. Khalwade@yahoo.fr
Diatta
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B
D003422:Critical Care; D003906:Developing Countries; D006772:Hospitals, Military; D006784:Hospitals, Teaching; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D011446:Prospective Studies; D012675:Senegal; D014140:Tracheotomy / Q000379:methods*; D016896:Treatment Outcome; D014329:Tropical Climate