|. 2017; 23(4): 149-152 | DOI: 10.5222/GKDAD.2017.149|
Pneumothorax in tracheostomy patient with late onsetİbrahim Mungan, Sema Turan, Dilek Kazancı, Büşra Tezcan, Derya Ademoğlu, Sultan Sevim Yakın, Mehmet Erdem Çakmak, Çilem Bayındır DicleTurkey High Specialty Hospital, İntensive Care Clinic, Ankara,Turkey
The tracheostomy is recommended for endotracheal intubation applied patients who resumed to be mechanical ventilator dependent. Percutaneous tracheostomy (PDT) is simple with low complication rate and it can be applied as bed- side procedure. It is an invasive procedure and may lead to mostly mild complications but, life-threatening complications like pneumothorax and pneumomediastinum have been reported as well.In this case presentation we examine pneumothorax developed patient two days after uncomplicated tracheostomy with the Griggs method. Our patient was 63 years old female, with the diagnosis of atherosclerotic heart disease had been operated. In terms of operation no shortage was developed in patient. After admitting to our intensive care clinic because of prolonged intubation percutaneous tracheostomy was decided to perform. Bronchoscopy assisted PDT with Griggs technique was performed and no complication was observed within 48 hours. Two days after subcutaneous crepitation and decrease in oxygen saturation was observed. A chest tube was inserted under local anesthesia after confirmation of pneumothorax with chest X-ray. Tracheostomy cannula was drew and the patient intubated again. Oxygen saturation via treatment improved however 2 days later the patient died after a cardiac arrest.In many studies it has been shown that percutaneous tracheostomy is superior to surgical method. But like all invasive procedures PDT is not innocent attempt and one of the most serious complication is pneumothorax. Although it occured in relatively late period pneumothorax should be kept in mind and necessary treatment and interventions should start immediately.Keywords: Pneumothorax, late onset, tracheostomy
Trakeostomili Hastada Geç Dönemde Gelişen Pnömotoraksİbrahim Mungan, Sema Turan, Dilek Kazancı, Büşra Tezcan, Derya Ademoğlu, Sultan Sevim Yakın, Mehmet Erdem Çakmak, Çilem Bayındır DicleTürkiye Yüksek İhtisas Hastanesi, Yoğun Bakım Kliniği,Ankara
Yoğun bakım ünitelerinde endotrakeal entübasyon uygulanan ve uzun süre mekanik ventilatöre bağlı kalacağı öngörülen hastalara trakeostomi açılması tavsiye edilmektedir. Perkütan trakeostomi (PDT) basit, komplikasyon hızı düşük ve hasta yatağında kısa sürede uygulanabilen bir yöntemdir. Yine de invaziv bir girişim olan PDT ile gelişebilen komplikasyonlar genelde hafif olmasına rağmen bazen pnömotoraks, pnömomediastinum gibi hayatı tehdit eden komplikasyonlar da bildirilmiştir. Bu vaka sunumunda Griggs yöntemi ile komplikasyonsuz açılan trakeostomiden 2 gün sonra gelişen pnömotoraks olgusunu inceledik.
İbrahim Mungan, Sema Turan, Dilek Kazancı, Büşra Tezcan, Derya Ademoğlu, Sultan Sevim Yakın, Mehmet Erdem Çakmak, Çilem Bayındır Dicle. Pneumothorax in tracheostomy patient with late onset. . 2017; 23(4): 149-152
Corresponding Author: İbrahim Mungan, Türkiye