AN INSTITUTIONAL STUDY: AUDIT OF SURGICAL TRACHEOSTOMY INDICATIONS, TECHNIQUES, AND COMPLICATIONS IN THE ICU.

Background: This retrospective study aimed to evaluate the indications, timing, and complications of surgical tracheostomy performed in the intensive care unit (ICU). Methods: We reviewed the records of 78 patients who underwent surgical tracheostomy in the ICU at GIMSH between July 2024 and Feb 2025. All procedures were performed in the operating theater under monitored anesthetic care. Patients were followed for one year post-operatively. Results: The primary indication for tracheostomy was prolonged mechanical ventilation (76 patients), with diaphragmatic palsy accounting for the remaining two. Early tracheostomy (1-7 days post-intubation) was performed in 14 patients, while late tracheostomy (8-14 days post-intubation) was performed in 64 patients. Early complications included hemorrhage in 7 patients and surgical emphysema in 3 patients. Conclusion: Prolonged mechanical ventilation is the predominant indication for surgical tracheostomy, typically performed between 8 and 14 days post-intubation. While operating room procedures are preferred for optimal outcomes, ICU bedside tracheostomies may be necessary in emergency situations to mitigate morbidity and mortality. Close post-operative monitoring is crucial to manage potential life-threatening complications.