Improvement of the Dilatational Tracheostomy Technique
https://doi.org/10.35401/2541-9897-2023-26-3-94-98
Abstract
Objective: To describe an improved technique for dilatational tracheostomy.
Clinical case: We report a case of severe community-acquired polysegmental viral pneumonia, grade 2 respiratory failure. After the start of antiviral therapy and staged respiratory support, the female patient was placed on mechanical ventilation 12 hours following hospital admission due to an increasing systemic inflammatory response and cytokine storm. In 20 hours, a dilatational tracheostomy using a modified technique was performed. Advantages of the modified technique are low trauma, short duration (5-10 minutes), significantly rarer wound infection (important benefit due to the COVID-19 features), significantly rarer postoperative scarring and cicatricial stenosis of the trachea. Technical improvement of dilatational tracheostomy allows for optimal management of critically ill patients (multiple organ failure, severe sepsis, considerable total body surface area burns with concomitant inhalation injury), which will significantly increase treatment efficiency, reduce the number of complications, and speed up the hospital discharge.
About the Authors
V. A. Porhanov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Vladimir A. Porhanov, Academician of the Russian Academy of Sciences, Dr. Sci. (Med.), Professor, Chief Physician, Head of the Department
Oncology Department with the Thoracic Surgery Course
Krasnodar
V. V. Shtraub
Kuban State Medical University
Russian Federation
Russian Federation
Vladimir V. Shtraub, Surgeon
Krasnodar
S. B. Bogdanov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Sergei B. Bogdanov, Dr. Sci. (Med.), Head of the Unit, Professor
Burns Unit
Department of Orthopedics, Traumatology, and Field Surgery
350086
ulitsa 1 Maya 167
Krasnodar
M. L. Mukhanov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Mikhail L. Mukhanov, Cand. Sci. (Med.), Traumatologist-Orthopedist, Associate Professor
Department of Orthopedics, Traumatology, and Field Surgery
Krasnodar
S. L. Zaitseva
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Sophia L. Zaitseva, Functional Diagnostics Specialist
Krasnodar
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Review
For citations:
Porhanov V.A., Shtraub V.V., Bogdanov S.B., Mukhanov M.L., Zaitseva S.L. Improvement of the Dilatational Tracheostomy Technique. Innovative Medicine of Kuban. 2023;(3):94-98. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-3-94-98
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