Tracheostomy in Intensive Care Unit: Indications, Benefits and Complications

2015 ◽  
Vol 21 (1) ◽  
pp. 28-32
Author(s):  
Muddassir Mahmud ◽  
Md Abul Hossain ◽  
Md Zakaria Sarkar ◽  
HS Mubarak Hossain ◽  
Md Obaidul Islam ◽  
...  

Objectives: To see the common indications of tracheostomy in ICU in this country, to compare the benefits over endotracheal intubation and to find out the pattern of complication of tracheostomy in the ICU to enrich the ideas for minimizing the complications.Methods: This is a cross sectional study was carried out at the Department of Otolaryngology and Head-Neck Surgery and Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University & Dhaka Medical college Hospital, Dhaka from October 2012 to march 2013.This study includes all ICU patients, irrespective of age and sex, whose tracheostomy has done after admission in Intensive Care Unit.Results: The study revealed that the commonest indication of tracheostomy in the ICU was head injury with history of RTA (27.5%), followed by post operative case of Intracranial space occupying lesion (25%). Next common indications were Guillain-Barre syndrome (15%), cerebrovascular accident (12.5%), Maxillofacial trauma (5%), RTA with cervical spinal cord injury (5%), and post operative pneumonia (5%)., Regarding benefits of tracheostomy over endotracheal intubation in ICU we found that 100% patient had greater comfort.The rate of complication of tracheostomy in ICU was 10% in this study. Surgical emphysema was the commonest complications (5%) followed by haemorrhage(2.5%) and tube displacement(2.5%).Bangladesh J Otorhinolaryngol; April 2015; 21(1): 28-32

Author(s):  
Mukhlesur Rahman ◽  
Mahmuda Begum ◽  
Mujibul Hoque Khan ◽  
Mostsfa Mahfuzul Anwar

<p><strong> </strong></p><p class="abstract"><strong>Background:</strong> Tracheostomy is a commonly performed surgical procedure in the intensive care unit (ICU) in which creation of a stoma between the skin and the anterior wall of the trachea where there is need for prolong mechanical ventilation. Tracheostomy has considered a safe procedure in ICU but has been found to lead to life threatening complications intra and post operatively.</p><p class="abstract"><strong>Methods:</strong> This is a cross sectional study, was carried out in ICU, Chittagong Medical College Hospital, Chattogram from January 2018 to December 2019. A total of 120 patients irrespective of age and sex whose tracheostomy has done after admission in ICU by ENT surgeons.  </p><p class="abstract"><strong>Results:</strong> Out of 120 patients maximum 34 (28.33%) were from 21-30 years age group and male to female ratio was 1.79:1, male patients were 77 (64.16%) and female patients were 43 (35.83%). The most common indication for tracheostomy in ICU was head injury and history of RTA 34 (28.33%) followed by post-operative case of intracranial space occupying lesion 30 (25%). Post tracheostomy complication was surgical emphysema 4 (3.33%). The rate of complication of tracheostomy in ICU was 10.83% in this study. Regarding benefits of tracheostomy over endotracheal tube in ICU, we found that 100% patients had greater comfort.</p><p class="abstract"><strong>Conclusions:</strong> Tracheostomy in ICU is an important and safe procedure if prolonged endotracheal in tubation is advised for varying underlying causes.</p>


2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44


2014 ◽  
Vol 19 (2) ◽  
pp. 82-86 ◽  
Author(s):  
Kazi Atikuzzaman ◽  
Khabir Uddin Ahmed ◽  
Mahmudul Hassan

Objectives: To find out the pattern of complications, frequency, risk factors and the management after total laryngectomy. Methods: It was a cross sectional study done in the Department of Otolaryngology & Head- Neck Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka from July 2007 to Dec 2009. 15 patients undergoing total laryngectomy for histologically proven Carcinoma larynx were included in this study. Patients were reviewed after surgery and any complication that occurred was recorded. The presentation, diagnosis and management of these complications were discussed after total laryngectomy. Results: There were 15 male patients, 3 non radiated cases and 12 post irradiated cases. Age of patients ranged from 35-75 years. Complications included wound infection (04), pharyngocutaneous fistula (03), flap necrosis (01), pharyngeal stenosis (01), stomal stenosis (01) and stomal recurrence (01). Conclusions: Wound infection and pharyngocutaneous fistula are most common complications after total laryngectomy. Preoperative radiotherapy is an important risk factor for development of pharyngocutaneous fistula in total laryngectomy patients. DOI: http://dx.doi.org/10.3329/bjo.v19i2.16366 Bangladesh J Otorhinolaryngol 2013; 19(2): 82-86


2015 ◽  
Vol 21 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Ashim Kumar Biswas ◽  
Nasima Akhtar ◽  
Timir Kumar Debnath ◽  
Anita Sarkar ◽  
Kazi Sameemus Salam

Objectives: To find out the complication of parotid surgery and association of nerve injury with the type of disease pathology and type of parotid surgery.Methods: This cross-sectional study on 30 cases was carried out in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University & Dhaka Medical College Hospital, Dhaka from September 2011 to September 2012. After taking history, clinical examination and investigation (FNAC, CT-scan) diagnosis was confirmed by histopathological examination.Results: In this study, lowest age was 14 years and highest age 65 years, male to female ration was 1.1:1. 83.33% cases were benign and 16.67% cases were malignant. Most of benign tumors was pleomorphic adenoma (80%). 88% cases involved in superficial lobe. Temporary facial nerve paresis was the most common postoperative complication (29.97%); 6.6% cases develoved permanent facial palsy and hypoesthesia of ear was 26.04%. Most patient regained normal facial nerve function within 6 months from the onset.Conclusion: Marginal mandibular nerve is the most common branch of facial nerve injury.Bangladesh J Otorhinolaryngol; April 2015; 21(1): 23-27


1970 ◽  
Vol 14 (2) ◽  
pp. 57-62
Author(s):  
A Allam Choudhury ◽  
Tuhin Sultana ◽  
Md Abul Hasnat Joarder ◽  
Kamrul Hassan Tarafder

This is a cross sectional study done in I.C.U & Dept. of otolaryngology - Head & Neck Surgery, B.S.M.M.U, Dhaka and Dhaka Medical College Hospital during the period of 1st March, 2003 to 30th August, 2003. 60 cases of tracheostomies, were included in this study, among them 30 cases of elective tracheostomies and 30 cases of emergency tracheostomies. In this study mean age of elective tracheostomy was 40.46 years & mean age of emergency tracheostomy was 50.50 years. Here Male was predominant both in elective (M:F= 6.5:1) and emergency tracheostomy (9:1). The common indications of elective tracheostomy were ICSOL (26.67%) & Head injury (26.67%) where as commonest indication of emergency tracheostomy was laryngeal carcinoma (53.33%). The frequency of complication for elective tracheostomy was 9.99% and emergency tracheostomy 33.35%. Here complications were 3.33 times more common in cases of emergency tracheostomy then elective tracheostomy. Key-words: Tracheostomy, elective and emergency.  DOI: 10.3329/bjo.v14i2.3282 Bangladesh J of Otorhinolaryngology 2008; 14(2) : 57-62


2014 ◽  
Vol 19 (2) ◽  
pp. 99-103
Author(s):  
Md Momenul Haque ◽  
Mohammad Idrish Ali ◽  
Md Harun-Ar-Rashid ◽  
Md Tariqul Islam ◽  
Mujibur Rahman ◽  
...  

Objective: To observe the pattern of clinical presentation according to site of origin of sinonasal carcinoma. Methods: This cross-sectional study was done in the Department of Otolaryngology-Head and Neck Surgery, BSMMU and Dhaka Medical College Hospital, Dhaka during the period from January 2008 to December 2009. Patients of sinonasal carcinoma were evaluated by detailed history, clinical examination and relevant investigations. Results: The present study included 40 patients of sinonasal malignancy bearing age limits of 4 years to 75 years with mean age 48.29. Male and female ratio was 2.6:1. Most patients (77.5%) came from rural area and illiterate (40%) and most of them were farmers (40%), having poor socio-economic condition (50%). About 35% of them were smokers and more than one other personal habit. Majority patients presented with multiple sinuses involvements (72.5%) and among single sinus involvement maxillary sinus was most common (63.63%), followed by nasal cavity (27.27%) and ethmoidal sinus (9.09%) as primary site. Conclusion: Though carcinoma of the nose and paranasal sinuses is relatively uncommon, it is not uncommon in our country. This disease generally presents in an advanced stage. Overall prognosis was directly related to diseases stages. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17632 Bangladesh J Otorhinolaryngol 2013; 19(2): 99-103


2016 ◽  
Vol 34 (1) ◽  
pp. 3-8
Author(s):  
Md Harun Ar Rashid Talukder ◽  
Md Monwar Hossain ◽  
Md Tariqul Islam ◽  
Mohammad Idrish Ali ◽  
Mujibur Rahman ◽  
...  

Objectives: To see the way of presentation of extracranial complication, relationship between socio-economic conditions and extracranial complication of chronic suppuration otitis media.Methods: This is a cross-sectional study carried out in Department of Otolaryngology Head and Neck Surgery, Sir Salimullah Medical College & Mitford Hospital and Dhaka Medical College Hospital from 1st July 2009 to 30th June 2010. The diagnosis was made by detailed history, clinical examination & investigation. Analyzed data was presented by various tables.Results: In this study male (59%), lower class people (57%), age 11-20 years, rural (66%) and less educated patients were more affected. Having bath in the ponds and rivers suffers more. Clinical presentation of CSOM with complications were aural discharge (100%), hearing impairment (94%), post auricular swelling (15%), pain in the ear (21%), postauricular discharge (27%) and mass in the EAC (12%). Here found aural discharge mostly malodorous and scanty, attic perforation and cholesteatoma. Post auricular abscess most common (47%) extracranial complication and labyrinthitis was the lowest (3%). Atticoantral variety was more common (89%) than that of tubotympanic disease (11%).Conclusion: From the review of the series we found the frequency & types of extracranial complications arising from CSOM and known the current epidemiological data. It can produce awareness among all level of medical practitioners and enhance prompt diagnosis and treatment.J Bangladesh Coll Phys Surg 2016; 34(1): 3-8


2019 ◽  
Vol 10 (05) ◽  
pp. 20737-20740
Author(s):  
Md Shazibur Rashid ◽  
Najnin Akter ◽  
Jahangir Alam Majumder ◽  
AHM Delwar ◽  
Md Golam Mustafa

Objectives: To determine the frequency of thyroid malignancy in clinically or zoographically multinodular goiter in patients undergoing thyroidectomy in Cumilla Medical College Hospital, Bangladesh. Methods: A cross sectional study was carried out at the department of Otolaryngology and Head Neck Surgery of Cumilla Medical College Hospital during the period from January 2016 to January 2019. This study includes all patients admitted and undergoing surgery with multinodular goiter. Results: Out of 146 patients 118 patients were female and 28 patients were male with female male ratio is 4.2:1. Out of 146 patients 13 patients were found histologically thyroid malignancy. Among them 8 patients were male and 5 patients were female. Papillary carcinoma was found in all cases.


2020 ◽  
Vol 23 (1) ◽  
pp. 59-66
Author(s):  
Muhammad Rafiqul Islam ◽  
Mohammad Abdullah ◽  
ABM Luthful Kabir ◽  
Syed Sanaul Islam ◽  
Mohammad Harun Or Rashid

Objectives: To evaluate the type and degree of hearing loss in CSOM and also to find out any relationship between the hearing loss and disease duration. Methods: This was a cross sectional study which was carried out in the departments of Otolaryngology and Head-Neck Surgery of BSMMU and Dhaka Medical College Hospital during the period of July’2011 to December’2011. A total 80 cases of CSOM were collected. Patient below the age of 5 years and patients above the age of 50 years were excluded from this study. The diagnosis of CSOM was established on the basis of clinical examination- otoscopy and tunning fork test. Pure tone audiogram (PTA) was done for hearing assessment. Thus, 80 cases of CSOM were collected with their PTA reports of 117 ears. Results: The study included 80 patients of CSOM, of them 60 were with tubo-tympanic type and 20 were with attico-antral disease. Highest number of patients was in 2nd decade in both type of disease. 44.79% of ears of tubo-tympanic type were associated with mild (26-40 dB) hearing loss and 42.85% attico-antral variety was with moderate (41-55 dB) hearing loss. Conductive type of hearing loss was common in both types of disease. 98% of ears in tubotympanic and 81% of ears in attico-antral disease had conductive hearing loss. Mixed type (2.08%) of hearing loss was found in tubo-tympanic disease. Attico-antral disease was also associated with mixed (14.28%) and SNHL (4.76%). Conclusion: The above study revealed that hearing loss in CSOM is mostly conductive in nature rarely sensorineural in type. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 59-66


2016 ◽  
Vol 21 (2) ◽  
pp. 85-89
Author(s):  
Md Nazmul Islam ◽  
Dipankar Lodh ◽  
Mohammad Mamun Siddiqui ◽  
AF Mohiuddin Khan ◽  
Kazi Meherunnesa

A Cross-Sectional Study was carried out from July 2006 to June 2007 at Department of Otolaryngology and Head-Neck Surgery of Dhaka Medical College Hospital, Dhaka. Data was collected from 150 patients with histologically diagnosed Hypopharyngeal carcinoma. Results of this study showed that hypopharyngeal carcinoma affects more in fifth (36.7%) and sixth (27.4%) decades of life. It was found that male were highly predominant to develop hypopharyngeal carcinoma and male female ratio was 9:1. People with lower educational level were found to be affected more by hypopharyngeal carcinoma. In this study 86 percent patients had history of smoking. Mean duration of smoking was 38.0±23.6 years. This study found that the key symptoms of hypopharyngeal carcinoma was dysphagia, pain and neck mass. In this study 83.5 percent patients presented with palpable lymph node and most (76.6%) of them were in level II. Pyriform fossa was found to be the commonest site (83.3%). In this study all malignancy in hypopharynx was histopathologically squamous cell carcinomaBangladesh J Otorhinolaryngol; October 2015; 21(2): 85-89


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