Changes in Early Infection Parameters After Percutaneous Tracheotomy

INTRODUCTION: Although tracheotomy (TO) is preferred in patients who require long hospital stays and mechanical ventila-tion (MV) support in the intensive care unit (ICU), it is a procedure that carries serious complications such as bleeding, tracheal damage, pneumothorax, emphysema, and infection. In our retrospective study, we evaluated early infection parameters after percutaneous TO. We also aimed to evaluate changes made in the first 48 h after TO without any other reason.
METHODS: We retrospectively evaluated the data of 125 patients who underwent TO between January 2018 and June 2019 by obtaining the permission of the scientific study committee of our hospital with the decision numbered 170173117–05006. In our clinic, percutaneous TO is performed at the bedside in accordance with sterile asepsis conditions. If the patient who underwent the procedure does not use antibiotics, prophylactic antibiotics are not administered. In our study, demographic data of the patients, APACHE-II, SAPS-2, primary diagnosis, TO opening time, C-reactive protein before and after tracheotomy, leukocytes, neutrophil–lymphocyte ratio, MV day time, ICU discharge, and presence of mortality were examined.
RESULTS: The mean age was 70±17.3, APACHE–II mean was 17.1±6.3, and mortality was 36.4%. No antibiotic changes were detected after TO. No differences were observed in the infection parameter changes after TO and the percentage change rates of infection parameters according to the presence of antibiotic use.
DISCUSSION AND CONCLUSION: Since the TO opening period is usually after the 10th day of intensive care hospitalization, patients may show signs of infection due to other causes. We are of the opinion that percutaneous TO applications in intensive care may also be a primary source of infection, and therefore, it is necessary to pay attention to the follow-up of infection parameters in this period.