Tracheotomy in Intensive Care: Techniques, Indications and Complications in a Series of 52 Cases in the Gabriel Toure University Hospital

The aim of our work was to identify the indications and to assess complications of tracheostomy in the intensive care setting. This work to retrospectively analyze the files of patients with tracheostomies in the multipurpose intensive care unit of the Gabriel Toure university Hospital in Bamako over 4 years from January 2016 to December 2020, including all patients with tracheostomies in intensive care or in operating room by surgical teams. The parameters taken into account were: the reasons for admission to intensive care unit, the history, the duration of intubation and ventilation before tracheostomy, the duration of total cannulation, the complications that arose during the performance of the procedure, immediately postoperatively and late. The mean age of our patients was 31.97 ± 19.03 years with extremes of 0.25 and 79 years. The sex ratio was 2.25 in favour of the male. The circumstances of hospitalization in intensive care are dominated which are neither respiratory nor neurological. The tracheotomy was performed in 52 patients, 21 patients in the operating room by an otolaryngologist including 2 in trans-isthmic and 31 times in the intensive care unit (intensive care) by an otolaryngologist team including 11 case in trans-isthmic. Tracheostomy was performed on average 2.6 ± 5.03 days after MV initiation (Median = 2 days), with extremes ranging from 0 to 45 days. Among the 52 patients included in our study, 27 patients (51.9%) underwent a tracheostomy during the first two days of MV (early tracheostomy group) and 25 patients (48.08%) underwent a tracheostomy beyond the second day of VM (Late tracheostomy group). During our study, no decanulation was carried out in the intensive care unit, the number of places reduced, does not allow hospitalized patients of which tracheostomies remain there after a slight improvement. The postoperative consequences were simple in 12 patients, or 23.1%.