Skip to main content
Top
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 1/2019

01-10-2019 | Original Article

Study of Demographic Profile of Organophosphate Compound Poisoning with Special Reference to Early Versus Late Tracheostomy in Tertiary Care Hospital in Rural Area

Authors: M. A. Kawale, S. H. Gawarle, P. N. Keche, S. V. Bhat

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 1/2019

Login to get access

Abstract

Tracheostomy is commonly performed life saving procedure. Organophosphorus compound poisoning is a very common emergency encountered in rural area where major population consists of agricultural workers. Ideal timing of tracheostomy is still controversial. Aim of the study is to assess the advantage of performing early (48 h–7 days) versus late tracheostomy (8–15 days) with regard to weaning from a ventilator, complications and length of hospital stay. This is a comparative retrospective interventional study in which 100 patients of organophosphorus poisoning who underwent tracheostomy during hospital stay due to prolonged intubation were analyzed. Study subjects were divided into two groups. Each group constitute of 50 patients each. Group A: Early tracheostomy (48 h–7 days) and Group B: Late tracheostomy (8–15 days). Early tracheostomy required a shorter duration of mechanical ventilator support (4–5 days) when compared to late tracheostomy (5–8 days), p < 0.05 and early tracheostomy facilitate early weaning. There was high incidence of complications in late tracheostomy group as compare to early tracheostomy group. Duration of hospital stay was also longer in Group B (mean 40 days) as compare to Group A (mean 32 days) with p < 0.05. We concluded that, early tracheostomy was associated with shorter duration of mechanical ventilator support, it helps for early weaning, shorted intensive care unit and hospital stay as compare to late tracheostomy.
Literature
1.
go back to reference Pracy P (2008) Tracheostomy in Scott-Brown’s otolaryngology. In: Head and neck surgery, 7th edn, vol 2. Hodder Arnold Pracy P (2008) Tracheostomy in Scott-Brown’s otolaryngology. In: Head and neck surgery, 7th edn, vol 2. Hodder Arnold
2.
go back to reference Bradley PJ (1997) Management of the obstructed airway and tracheostomy. In: Scott-Brown’s otorhinolaryngology, head and neck surgery 6 th edn, vol 5. Butterworth-Heinemann Bradley PJ (1997) Management of the obstructed airway and tracheostomy. In: Scott-Brown’s otorhinolaryngology, head and neck surgery 6 th edn, vol 5. Butterworth-Heinemann
3.
go back to reference Klunge S, Baumann HJ, Maier C, Klose H, Meyer A, Nierhaus A, Kreymann G (2008) Tracheostomy in intensive care unit: a nationwide survey. Anesth Analg 107(5):1639–1643CrossRef Klunge S, Baumann HJ, Maier C, Klose H, Meyer A, Nierhaus A, Kreymann G (2008) Tracheostomy in intensive care unit: a nationwide survey. Anesth Analg 107(5):1639–1643CrossRef
4.
go back to reference Boubaker C, Abdelhamid H, Abdellatif B et al (2009) Tracheostomy versus prolonged intubation in medical intensive care unit. Signa Vitae 4(1):21–23CrossRef Boubaker C, Abdelhamid H, Abdellatif B et al (2009) Tracheostomy versus prolonged intubation in medical intensive care unit. Signa Vitae 4(1):21–23CrossRef
5.
go back to reference Zheng X, Zhu J, Yu Q (2011) Current situation and advance of APACHE-II score in clinical application. Med Recapitulate 21:034 Zheng X, Zhu J, Yu Q (2011) Current situation and advance of APACHE-II score in clinical application. Med Recapitulate 21:034
7.
go back to reference Heffner JE, Hess D (2001) Tracheostomy management in the chronically ventilated patient. Clin Chest Med 22(1):55–69PubMedCrossRef Heffner JE, Hess D (2001) Tracheostomy management in the chronically ventilated patient. Clin Chest Med 22(1):55–69PubMedCrossRef
8.
go back to reference Criner GJ, Tzouanakis A, Kreimer DT (1994) Overview of improving tolerance of long-term mechanical ventilation. Crit Care Clin 10(4):845–866PubMedCrossRef Criner GJ, Tzouanakis A, Kreimer DT (1994) Overview of improving tolerance of long-term mechanical ventilation. Crit Care Clin 10(4):845–866PubMedCrossRef
9.
go back to reference Armstrong PA, McCarthy MC, Peoples JB (1998) Reduced use of resources by early tracheostomy in ventilator-dependent patients with blunt trauma. Surgery 124(4):763–766PubMedCrossRef Armstrong PA, McCarthy MC, Peoples JB (1998) Reduced use of resources by early tracheostomy in ventilator-dependent patients with blunt trauma. Surgery 124(4):763–766PubMedCrossRef
10.
go back to reference Plummer AL, Gracey DR (1989) Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest 96(1):178–180PubMedCrossRef Plummer AL, Gracey DR (1989) Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest 96(1):178–180PubMedCrossRef
11.
go back to reference Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB (2004) A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med 32(8):1689–1694PubMedCrossRef Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB (2004) A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med 32(8):1689–1694PubMedCrossRef
12.
go back to reference Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB et al (2010) Early vs late tracheotomyfor prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA 303(15):1483–1489PubMedCrossRef Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB et al (2010) Early vs late tracheotomyfor prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA 303(15):1483–1489PubMedCrossRef
13.
go back to reference Rodriguez JL, Steinberg SM, Luchetti FA, Gibbons KJ, Taheri PA, Flint LM (1990) Early tracheostomy for primary airway management in the surgical critical care setting. Surgery 108(4):655–659PubMed Rodriguez JL, Steinberg SM, Luchetti FA, Gibbons KJ, Taheri PA, Flint LM (1990) Early tracheostomy for primary airway management in the surgical critical care setting. Surgery 108(4):655–659PubMed
14.
go back to reference Arabi Y, Haddad S, Shirawi N, Al Shimemeri A (2004) Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review. Crit Care 8(5):R347–R352PubMedPubMedCentralCrossRef Arabi Y, Haddad S, Shirawi N, Al Shimemeri A (2004) Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review. Crit Care 8(5):R347–R352PubMedPubMedCentralCrossRef
15.
go back to reference Lesnik I, Rappaport W, Fulginiti J, Witzke D (1992) The role of earlytracheostomy in blunt, multiple organ trauma. Am Surg 58(6):346–349PubMed Lesnik I, Rappaport W, Fulginiti J, Witzke D (1992) The role of earlytracheostomy in blunt, multiple organ trauma. Am Surg 58(6):346–349PubMed
16.
go back to reference D’amelio LF, Hammond JS, Spain DA, Sutyak JP (1994) Tracheostomy and percutaneous endoscopic gastrostomy in the management of the head injured trauma patient. Am Surg 60(3):180–185PubMed D’amelio LF, Hammond JS, Spain DA, Sutyak JP (1994) Tracheostomy and percutaneous endoscopic gastrostomy in the management of the head injured trauma patient. Am Surg 60(3):180–185PubMed
17.
go back to reference Bouderka MA, Fakhir B, Bouaggad A, Hmamouchi B, Hamoudi D, Harti A (2004) Early tracheostomy versus prolonged endotracheal intubation in severe head injury. J Trauma Acute Care Surg 57(2):251–254CrossRef Bouderka MA, Fakhir B, Bouaggad A, Hmamouchi B, Hamoudi D, Harti A (2004) Early tracheostomy versus prolonged endotracheal intubation in severe head injury. J Trauma Acute Care Surg 57(2):251–254CrossRef
18.
go back to reference Brook AD, Sherman G, Malen J, Kollef MH (2000) Early versus late tracheostomy in patients who require prolonged mechanical ventilation. Am J Crit Care 9(5):352–359PubMed Brook AD, Sherman G, Malen J, Kollef MH (2000) Early versus late tracheostomy in patients who require prolonged mechanical ventilation. Am J Crit Care 9(5):352–359PubMed
19.
go back to reference Sugerman HJ, Wolfe L, Pasquale MD, Rogers FB, O’Malley KF, Knudson M et al (1997) Multicenter, randomized, prospective trial of early tracheostomy. J Trauma Acute Care Surg 43(5):741–747CrossRef Sugerman HJ, Wolfe L, Pasquale MD, Rogers FB, O’Malley KF, Knudson M et al (1997) Multicenter, randomized, prospective trial of early tracheostomy. J Trauma Acute Care Surg 43(5):741–747CrossRef
20.
go back to reference Griffiths J, Barber VS, Morgan L, Young JD (2005) Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 330(7502):1243PubMedPubMedCentralCrossRef Griffiths J, Barber VS, Morgan L, Young JD (2005) Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 330(7502):1243PubMedPubMedCentralCrossRef
21.
go back to reference Dunham CM, Ransom KJ (2006) Assessment of early tracheostomy in trauma patients: a systemic review and meta-analysis. Am Surg 72:276–281PubMed Dunham CM, Ransom KJ (2006) Assessment of early tracheostomy in trauma patients: a systemic review and meta-analysis. Am Surg 72:276–281PubMed
22.
go back to reference Wang F, Wu Y, Bo L et al (2011) The timing of tracheostomy in critically ill patients undergoing mechanical ventilation: a systemic review and meta-analysis of randomized controlled trials. Chest 140:1456–1465PubMedCrossRef Wang F, Wu Y, Bo L et al (2011) The timing of tracheostomy in critically ill patients undergoing mechanical ventilation: a systemic review and meta-analysis of randomized controlled trials. Chest 140:1456–1465PubMedCrossRef
23.
go back to reference Major KM, Hui T, Wilson MT, Gaon MD, Shabot MM, Margulies DR (2003) Objective indications for early tracheostomy after blunt head trauma. Am J Surg 186(6):615–619 (discussion 619) PubMedCrossRef Major KM, Hui T, Wilson MT, Gaon MD, Shabot MM, Margulies DR (2003) Objective indications for early tracheostomy after blunt head trauma. Am J Surg 186(6):615–619 (discussion 619) PubMedCrossRef
25.
go back to reference Hsu CL, Chen KY, Chang CH, Jerng JS, Yu CJ, Yang PC (2005) Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study. Crit Care 9(1):R46–R52PubMedCrossRef Hsu CL, Chen KY, Chang CH, Jerng JS, Yu CJ, Yang PC (2005) Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study. Crit Care 9(1):R46–R52PubMedCrossRef
26.
go back to reference Brandwein M, Abramson AL, Shikowitz MJ (1986) Bilateral vocal cord paralysis following endotracheal intubation. Arch Otolaryngol Head Neck Surg 112:866–882CrossRef Brandwein M, Abramson AL, Shikowitz MJ (1986) Bilateral vocal cord paralysis following endotracheal intubation. Arch Otolaryngol Head Neck Surg 112:866–882CrossRef
27.
Metadata
Title
Study of Demographic Profile of Organophosphate Compound Poisoning with Special Reference to Early Versus Late Tracheostomy in Tertiary Care Hospital in Rural Area
Authors
M. A. Kawale
S. H. Gawarle
P. N. Keche
S. V. Bhat
Publication date
01-10-2019
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 1/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-017-1234-y

Other articles of this Special Issue 1/2019

Indian Journal of Otolaryngology and Head & Neck Surgery 1/2019 Go to the issue