About: Severe pain-related adverse events of percutaneous dilatational tracheostomy performed by a neurointensivist compared with conventional surgical tracheostomy in neurocritically ill patients

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About: Severe pain-related adverse events of percutaneous dilatational tracheostomy performed by a neurointensivist compared with conventional surgical tracheostomy in neurocritically ill patients Goto Sponge NotDistinct Permalink

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Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Severe pain-related adverse events of percutaneous dilatational tracheostomy performed by a neurointensivist compared with conventional surgical tracheostomy in neurocritically ill patients
Creator	Kim, Yong Chung, Chi Suh, Gee Park, Chi-Min Ryu, Jeong-Am
Source	PMC
abstract	BACKGROUND: We evaluated severe pain-related adverse events (SAE) during the percutaneous dilatational tracheostomy (PDT) procedure performed by a neurointensivist and compared the outcomes with that of conventional surgical tracheostomy in neurocritically ill patients. METHODS: This was a retrospective and observational study of adult patients who were admitted to the neurosurgical intensive care unit between January 2014 and March 2018 and underwent tracheostomy. In this study, primary endpoints were incidence of SAE: cardiac arrest, arrhythmias, hypertension, hypotension, desaturation, bradypnea, or ventilatory distress. The secondary endpoint was procedure-induced complications. RESULTS: A total of 156 patients underwent tracheostomy during the study. Elective surgery of brain tumors (34.0%) and intracranial hemorrhage (20.5%) were the most common reasons for admission. The most common reasons for tracheostomy were difficult ventilator weaning or prolonged intubation (42.9%) and sedative reduction (23.7%). Tachycardia (30.1%) and hypertension (30.1%) were the most common SAE. Incidence of SAE was more common in conventional tracheostomy compared to PDT (67.1% vs. 42.3%, P = 0.002). The total duration of SAE (19.8 ± 23.0 min vs. 3.4 ± 5.3 min, P < 0.001) and procedural time (42.2 ± 21.8 min vs. 17.7 ± 9.2 min, P < 0.001) were longer in conventional tracheostomy compared to PDT. Multivariable adjustment revealed that only PDT by a neurointensivist significantly reduced the incidence of SAE by one third (adjusted odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.187–0.691). In addition, PDT by a neurointensivist deceased the duration of SAE by 8.64 min (β: -8.64, 95% CI: − 15.070 – -2.205, P = 0.009) and prolonging the procedure time by every one minute significantly increased the duration of SAE by 6.38 min (β: 6.38, 95% CI: 0.166–0.470, P < 0.001). Procedure-induced complications were more common in conventional tracheostomy compared to PDT (23.5% vs. 11.3%, P = 0.047). CONCLUSIONS: This retrospective and exploratory study of our single-center limited cohort of tracheostomy patients revealed that decreased SAE may be associated with short procedural time during the PDT procedure performed by a neurointensivist. It is proposed that PDT by a neurointensivist may be safe and feasible in neurocritically ill patients.
has issue date	2020-06-03(xsd:dateTime)
bibo:doi	10.1186/s12883-020-01809-x
has license	cc-by
sha1sum (hex)	0249ae7331b87accdd8ad76f62c1a09dbbd9544b
schema:url	https://doi.org/10.1186/s12883-020-01809-x
resource representing a document's title	Severe pain-related adverse events of percutaneous dilatational tracheostomy performed by a neurointensivist compared with conventional surgical tracheostomy in neurocritically ill patients
has PubMed Central identifier	PMC7267757
schema:publication	BMC Neurol
resource representing a document's body	covid:0249ae7331b87accdd8ad76f62c1a09dbbd9544b#body_text
is schema:about of	named entity 'SAE' named entity 'secondary' named entity 'SAE' named entity 'tracheostomy' named entity 'retrospective' named entity 'compared' named entity 'ENDPOINTS' named entity 'TACHYCARDIA' named entity '166' named entity 'PERCUTANEOUS' named entity '470' named entity 'INTENSIVE CARE UNIT' named entity '2018' named entity 'MARCH' named entity 'BRAIN TUMORS' named entity 'RELATED' named entity 'OUTCOMES' named entity 'ADULT' covid:arg/0249ae7331b87accdd8ad76f62c1a09dbbd9544b named entity 'confidence interval' named entity 'arrhythmias' named entity 'time' named entity 'hypertension' named entity '2018' named entity 'weaning' named entity 'odds ratio' named entity 'Elective surgery' named entity 'Results' named entity 'duration' named entity 'surgical' named entity 'intubation' named entity 'brain tumors' named entity 'cardiac arrest' named entity 'hypertension' named entity 'Elective surgery' named entity 'hypertension' named entity 'percutaneous' named entity 'tracheostomy' named entity 'neurointensivist' named entity 'PDT' named entity 'ICU' named entity 'VAP' named entity 'ICU' named entity 'tracheostomy' named entity 'tracheostomy' named entity 'tracheostomy' named entity 'observational study' named entity 'hypotension' named entity 'tracheostomy' named entity 'comorbidities' named entity 'neurosurgical' named entity 'ICU' named entity 'incidence rate' named entity 'intubation' named entity 'intensive care unit' named entity 'incidence rate' named entity 'ventilator' named entity 'neurosurgical' named entity 'tracheostomy' named entity 'surgical treatment' named entity 'neurologic conditions' named entity 'tracheostomy' named entity 'neurointensivist' named entity 'tracheostomy' named entity 'bradypnea' named entity 'PDT' named entity 'Institutional Review Board' named entity 'Vital signs' named entity 'comorbidities' named entity 'tracheostomy' named entity 'PDT' named entity 'neurosurgeon' named entity 'tracheostomy' named entity 'PDT' named entity 'tracheostomy' named entity 'PDT' named entity 'correlation' named entity 'arterial pressure' named entity 'tracheostomy'

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