9. So sánh kết quả và biến chứng sớm của mở khí quản nong qua da được hỗ trợ bằng siêu âm với hỗ trợ bằng nội soi phế quản ống mềm

Abstract

The utilization of percutaneous dilational tracheostomy (PDT) has gained significant traction in intensive care units as a result of its perceived advantages in terms of safety and convenience. A randomized, interventional study was conducted at the Center for Anesthesia and Surgical Intensive Care, Bach Mai Hospital in 2023. The objective of the study was to compare the results, cardiovascular effects and early complications of PDT guided by ultrasound (US-PDT) and flexible bronchoscopy (BS-PDT). A total of sixty patients who had an indication for tracheostomy were divided into two groups (n = 30 in each group). The results indicated that the success rate of PDT was 100% in both groups. The duration of tracheostomy in the US-PDT group and the BS-PDT group was 4 minutes and 4.3 minutes, respectively (p > 0.05). As compared to the BS-PDT group, the US-PDT group required fewer analgesics and experienced fewer increases in heart rate and blood pressure (p < 0.05). Comparable incidences of minor hemorrhage complications occurred in both groups (6.7% vs. 16.7%, p > 0.05). None of the patients had any major complication. In conclusion, the utilization of flexible bronchoscopy or ultrasound to assist in PDT proved to be successful in every patient. The early complications were infrequent and comparable between the two groups; however, the degree of increased heart rate, increased blood pressure, and fentanyl consumption were lower in the US-PDT.