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AuthorEberhardt, Lars Karldc.contributor.author
Date of accession2016-03-14T15:23:07Zdc.date.accessioned
Available in OPARU since2016-03-14T15:23:07Zdc.date.available
Year of creation2008dc.date.created
AbstractOBJECTIVES: Data of 248 patients who underwent percutaneous dilatational tracheostomy (PDT) from 2003 to 2006 were analysed retrospectively. Main interests were to determine how many and when patients were treated, what differences existed in demographical data, preexisting conditions and main illness between the early (< or = 7 days) and the late (> 7 days) tracheostomy group, also, to determine clinical outcome early vs. late and sedative and noradrenaline administration before vs. after PDT. METHODS: Data were derived from an internal and a clinic-wide database, patient charts and doctor´s letters. Parameters were defined and analysed. Where reasonable, statistical tests were performed. RESULTS: The percentage of ICU patients undergoing PDT rose from 9.9 % in 2003 to 12.8 % in 2006. Median time from ICU admission to PDT was 7 days. Patients admitted for general surgery were significantly more common in the late group (41 vs. 24 %), neurosurgical patients in the early group (28 vs. 12 %). The late group was significantly more severely diseased measured by SAPS II. Other data did not correlate with timing of PDT. ICU stay was significantly shorter for the early group (17 days vs. 29 days late, median), while mortality, complication rates, number of re-dilatations and number of patients discharged with or without tracheal cannula, did not significantly differ. Doses of propofol, midazolam, sufentanil and noradrenaline (norepinephrine) compared 3 days before PDT to 3 days after were significantly reduced. DISCUSSION: Patients profited by early PDT which was reflected in a shorter ICU stay. After PDT, medication could be significantly reduced. Therefore, a common effect of reduced sedation, catecholamine administration and accelerated weaning from MV could possibly explain the shorter ICU stay. Some parameters were distributed inhomogeneously, which is why further studies are needed to find predictors for who will profit more by early PDT and who will less.dc.description.abstract
Languagededc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseCC BY-NC-ND 3.0 Deutschlanddc.rights
Link to license texthttp://creativecommons.org/licenses/by-nc-nd/3.0/de/dc.rights.uri
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHIntensive caredc.subject.mesh
TitleDie dilatative Tracheotomie auf der anästhesiologischen Intensivstation - retrospektive Analyse von Daten der Jahre 2003 bis 2006dc.title
Resource typeDissertationdc.type
DOIhttp://dx.doi.org/10.18725/OPARU-1599dc.identifier.doi
PPN1651368635dc.identifier.ppn
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-vts-68212dc.identifier.urn
GNDEntwöhnungdc.subject.gnd
GNDIntensivstationdc.subject.gnd
GNDKünstliche Beatmungdc.subject.gnd
GNDMidazolamdc.subject.gnd
GNDNoradrenalindc.subject.gnd
GNDPrädiktordc.subject.gnd
GNDPropofoldc.subject.gnd
GNDSufentanildc.subject.gnd
GNDTimingdc.subject.gnd
GNDTracheotomiedc.subject.gnd
FacultyMedizinische Fakultätuulm.affiliationGeneral
Date of activation2009-05-18T17:27:38Zuulm.freischaltungVTS
Peer reviewneinuulm.peerReview
Shelfmark print versionZ: J-H 13.259; W: W-H 11.697uulm.shelfmark
DCMI TypeTextuulm.typeDCMI
VTS ID6821uulm.vtsID
CategoryPublikationenuulm.category
Bibliographyuulmuulm.bibliographie


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