ĐÁNH GIÁ HIỆU QUẢ CỦA KỸ THUẬT MỞ KHÍ QUẢN XUYÊN DA NONG TẠI BỆNH VIỆN NGUYỄN TRI PHƯƠNG NĂM 2024-2025

Abstract

Background: Percutaneous dilatational tracheostomy (PDT), introduced by Ciaglia in 1985, has become widely adopted for its speed, safety, and minimally invasive nature. At Nguyen Tri Phuong Hospital, PDT has been routinely performed since 2013. In 2024, the hospital introduced an S-shaped dilator designed to enhance procedural stability and operator control. However, local data on this new device remain limited. This study aims to evaluate the safety and effectiveness of PDT using the S-shaped dilator. Methods: A descriptive study combining retrospective and prospective data was conduct 53 patients (mean age 66,72 ± 16,63 years; male/female 37,74%/62,26%) who had indications for percutaneous dilatational tracheostomy (PDT) at Nguyen Tri Phuong Hospital from November 2024 to June 2025. Demographic information and medical history were collected, after which PDT was performed. Postoperatively, vital signs and clinical parameters were recorded before and after the procedure; early complications (within 24 hours) and late complications (>24 hours after the procedure) were monitored, and surgical outcomes were documented. Results: Mean surgical time was 5,35 ± 1,07 minutes. Variables that changed significantly in a positive direction before and after surgery included pulse (90,45 ± 11,28 vs 87,16 ± 9,34  beats/minute, p = 0.028), SpO2 (97,92 ± 1,36 vs 98,74 ± 1,14,p = 0.004), and ETCO2 (47,63 ± 3,80 vs 42,08 ± 4,42, p < 0,001). The postoperative complications rate was 13,19%, including early complications (11,31%) and late complications (1,88%). There were 54,71 % of patients discharged without removing the cannula, 1,88% were discharged with the cannula removed, and 43,41% died. All patients who died were due to underlying diseases- ICU department, not PDT complications. Conclusion: PDT is a highly effective and safe technique for being trained and widely applied in medical facilities.