Elective Tracheotomy Practices in Turkey

Abstract

Objectives Elective tracheotomy (ET) procedures in intensive care units (ICU) might be different in accordance with countries and ICUs' features. The aim of the present study was to search the epidemiology of ET procedures in Turkey. Methods A questionnaire which consists of 43 questions was sent by e-mail to 238 ICUs which were officially recognized by The Turkish Ministry of Health. All answers were obtained between August 1, 2015 and August 31, 2015. Results Two hundred and three ICUs (85.3\%) participated in this study. 177 (87.2\%) and 169 (83.4\%) of ICU's were level III and mixed ICUs respectively. Anesthesiologists were the director of 189 (93.0\%) ICUs. Estimated total count of admitted, mechanically ventilated and tracheotomized patients in 2014 were 126282, 80569 (63.8\%) and 8989 (7.1\%) respectively. Most common indication for ET was prolonged mechanical ventilation (76.9\%). The first choice for ET procedure was percutaneous in 162 (79.8\%) ICUs. Griggs guide wire dilatational forceps (GWDF) technique was used as the first choice for elective percutaneous tracheotomy (EPT) by 143 (70.4\%) ICUs. Most common early EPT complication was bleeding (68.0\%) and late EPT complication was stenosis (35.0\%). While facilitation of weaning was most important advantage (26.1\%), bleeding and tracheal complications were most important disadvantages for EPT (29.1\%). Conclusions Most common indications for ET are prolonged MV and coma in Turkish ICUs. EPT is the preferred procedure for ET and GWDF is the most common technique. Bronchoscopy and USG are rarely used as a guide.