Zusammenfassung
Tracheotomien sind häufige Eingriffe bei beatmeten Intensivpatienten. Sie können mit schweren Komplikationen verbunden sein, bis hin zum tödlichen Ausgang. Die Komplikationen Blutung, Pneumothorax, Tracheahinterwandverletzungen, intraoperativer Verlust des Atemwegs, Verlust des Atemwegs bei Kanülenwechsel, Trachealringfrakturen, Trachealstenosen und Stomainfektionen werden für die verschiedenen Verfahren und Methoden in zahlreichen Abbildungen, Tabellen und Textbeschreibungen übersichtlich dargestellt sowie Strategien zu deren Vermeidung eingehend abgehandelt. Die Komplikationen werden erstmals im Schrifttum durch konkrete Angaben vergleichend definiert. Die Durchführung der PDT mit starrer endoskopischer Kontrolle wird unter interdisziplinären Aspekten ausführlich beschrieben. Tracheotomie-assoziierten Todesfällen ist ein eigenes Kapitel gewidmet. Das Kapitel ist für den praktisch tätigen Arzt in seinem zentralen Anliegen, Komplikationen zu vermeiden, eine Pflichtlektüre und für Gutachter eine hilfreiche Orientierung.
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Notes
- 1.
Tracheotomie-Endoskop für Dilatationstracheotomien (TED nach Klemm): Hersteller Karl Storz GmbH Tuttlingen, Germany, patentiert 30.11.2006, USA Pub. No. US2006/0270907A1 durch Karl Storz GmbH Tuttlingen.
EC-Declaration of Conformity: Karl Storz GmbH Tuttlingen 16.10.2008, Endoskope E, F, G.
Tracheoskop nach Aloy-Klemm: Hersteller Carl Reiner GmbH Wien, Austria, mit Anpassung zu TwinStream ™ Multi Mode Respirator der Firma Carl Reiner GmbH Medizintechnik für Diagnose und Therapie Wien, Produktkompatibilitätserklärung Wien 28.01.2008.
Literatur
Altmann E, Badaev R, Radynsky E, Croitoru M, Rosin I, Davidova N, Taitelman U (2006) Clinical and experimental assessment of Griggs percutaneous tracheostomy. J An Ints 13: 82–83
Araujo JB, Anon JM, Garcia de Lorenzo A, Garcia-Fernandez AM, Esparcia M, Adan J et al. (2017) Med intensive. https://doi.org/10.1016/j.medin.2017.05.005
Ayoub OM, Griffiths MV (2006) Aortic arch laceration: a lethal complication after percutaneous tracheostomy. Laryngoscope 117: 1–3
Beiderlinden M, Adamzik M, Peters J (2005) Conservative treatment of tracheal injuries. Anesth Analg 100: 210–214
Bhatti N, Mirski M, Tatlipinar A et al. (2007) Reduction of complication rate in percutaneous dilation tracheotomies. Laryngoscope 117: 172–175
Byhahn CH, Westphal K, Meiniger D, Gürke B, Kessler P, Lischke V (2002) Single dilator percutaneous tracheostomy: a comparison of Percu Twist and Ciaglia Blue Rhino techniques. Intensive Care Med 28: 1262–1266
Christenson TE, Artz GJ, Goldammer, JE, Spiegel JR, Boon MS (2008) Tracheal stenosis after placement of percutaneous dilational tracheotomy. Laryngoscope 118: 222–227
Ciaglia P (1999) Technique, complications and improvements in percutaneous dilatational tracheostomy. Chest 115: 1229–1230
Decker S, Gottlieb J, Cruz D, Müller CW, Wilhelmi M, Krettek C (2016) Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure. Eur J Trauma Emerg Surg. 42 (5): 605–610
Delaney A, Bagshaw SM, Nalos M (2006) Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care 10 (2): R55
Delank KW, Schmäl F, Stoll W (2002) HNO-ärztliche Erfahrungen mit traumatischen Läsionen der Tracheahinterwand. Laryngo-Rhino-Otol 81: 299–304
Dempsey GA, Grant CA, Jones TM (2010) Percutaneous tracheostomy: a 6 year prospective evaluation of the single tapered dilator technique. BJA 105 (6): 782–788
Dempsey GA, Morton B, Hammell C, Williams LT, Smith CT, Jones T (2016) Longterm outcome following tracheostomy in critical care: A systematic review. Crit Care Med 44 (3): 617–628
Deitmer TH, Delank K (1995) Kritische Anmerkungen aus HNO-ärztlicher Sicht zur perkutanen dilatativen Tracheotomie nach Ciaglia. Anaesthesiol Intensivmed Notfallmed Schmerzther 30: 501–503
Diaz-Reganon G, Minambres E, Ruiz A, Gonzales-Herrera S, Holanda-Pena M, Lopez-Espadas F (2008) Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients. Anaesthesia 63:1198–1203
Dollner, R, Verch M, Schweiger P, Deluigi C, Graf B, Wallner F (2002) Laryngotracheoscopic findings in longterm follow-up after Griggs tracheostomy. Chest 122: 206–212
Dongelmans DA, van der Lely AJ, Tepaske R, Schultz M (2004) Complications of percutaneous dilating tracheostomy. Crit Care 8: 397–398
Dost P, Koeser K (1999) Komplikationen der dilatativen Punktionstracheotomien in deutschen Hals-Nasen-Ohren-Abteilungen. Laryngo-Rhino-Otol 78: 81–85
Escarment J, Suppini A, Sallaberry M, Kaiser E et al. (2000) Percutaneous tracheostomy by forceps dilation: report of 162 cases. Anaesthesia 55: 125–130
Fantoni A (2006) The need to compare different techniques of tracheostomy in a more reliable way. J An Ints 13: 61–64
Fantoni A, Ripamonti D (1997) Eine nicht abgeleitete nicht-chirurgische Tracheotomie-Technik: Die translaryngeale Tracheotomie. Intensive Care Med 23: 386–392
Fattahi T, Vega L, Fernandes R, Golman N, Steinberg B, Schare H (2012) Our experience with 171 open tracheotomies. J Oral Maxillofac Surg 70: 1699–1702
Ferraro F, Marfella R, Esposito M, Petruzzi J, Torino A, Santini M, Fiorelli A (2015) Tracheal ring fracture secondary to percutaneous tracheostomy: is tracheal flaccidity a risk factor? J Cardiothorac Vasc Anaesth 29 (3): 560–564
Fikkers BG, Van Veen JA, Kooloos JG, Fickkers P, Van den Hoogen F et al. (2004) Emphysema andpneumothorax after percutaneous tracheostomy: case reports and anatomic study. Chest 125: 1805–1814
Fiorini F, Santoro R, Deganello A, Mannelli G, Meccarariello G, Gallo O (2015) Is open tracheotomy performed by residents in otolaryngology a safe procedure? a retrospective cohort study. Eur Arch Otolaryngol 272: 1483–1489
Frova G, Quintel M (2002) A new simple method for percutaneous tracheostomy: controlled rotating dilation. Intensive Care Med 28: 299–303
Gadkaree SK, Pandian V, Best S, Motz KM, Allen C, Kim Y, Akst L, Hillel AT (2017) Laryngotracheal Stenosis: Risk Factors for Tracheostomy Dependence and Dilation Interval. Otolaryngol Head Neck Surg 156(2): 321–328
Gambale G, Cancellieri F, Baldini U, Vacchi Suzzi M, Baroncini S, Ferrari F, Petrini F (2003) Ciaglia percutaneous dilational tracheostomy: Early and late complications and follow-up. Minerva Anestesiologica 69: 825–833
Gomez-Caro A, Diez F, Herrero P, Gude V, Cabrero E, Porch E, Nicolas J (2005) Successful conservative management in iatrogenic tracheobronchial injury. Ann Thorax Surg 79: 1872–1878
Halum SL, Ting JY, Plowman EK, Belafsky PC, Harbarger CF, Postma GN, Pitman MJ et al. (2011) A multi-institutional analysis of tracheotomy complications. Laryngoscope 122: 38–45
Hashemian SM, Digaleh H (2015) A prospective randomized study comparing mini-surgical percutaneous dilatational tracheostomy with surgical and classic percutaneous tracheostomy. Medicine (Baltimore) 94 (47): e2015
Hazelton JP, Orfe EC, Calcino AM, Hunter K, Capano-Wehrle LM, Lachant MT et al. (2015) The impact of a multidisciplinary safety checklist on adverse procedural events during bedside bronchoscopy-guided percutaneous tracheostomy. J Trauma Acute Care Surg 79 (1): 111–116
Heurn van LW, Goei R, de Ploeg I, Ramsay G, Brink PR (1996) Late complications of percutaneous dilatational tracheotomy. Chest 110: 1572–1576
Higgins D, Bunker N, Kinnear J (2009) Follow-up of patients with tracheal ring fractures secondary to antegrade percutaneous dilational tracheostomy. Eur J Anaesthesiol 26 (2): 147–149
Hill B, Zweng T, Maley R, Charash W, Toursarkassian B, Kearny PA (1996) Percutaneous dilatational tracheostomy: report of 356 cases. J Trauma 41 (2): 238–244
Jung HP, Henker M, Klemm E (2004) Langzeitergebnisse nach intercartilaginärer Visier-Tracheotomie. Mitteilungen Norddeutsche Gesellschaft für Otorhinolaryngologie und zervikofaziale Chirurgie. Demeter, S 43–46
Kearny PA, Griffen MM, Ochoa JB, Boulanger BR, Tseui BJ, Mentzner RM (2000) A Single-center 8-year experience with percutaneous dilatational tracheostomy. Annals Surg 231 (5): 701–709
Kedjanyi WK, Gupta D (2001) Near total transection of the trachea following percutaneous dilatational tracheostomy. J R Coll Surg Edinb 46: 242–243
Klemm E (2006) Das Tracheotomie-Endoskop für Dilatationstracheotomien. Laryngo-Rhino-Otol 85: 628–832
Klemm E, Nowak A (2006) Das Tracheotomie-Endoskop für Dilatationstracheotomien (TED), erste Vorstellung eines neuen Verfahrens der HNO-Heilkunde und Intensivmedizin. J An Ints 13: 58
Klemm E, Nowak A (2017) Tracheotomy-related death –a systematic review. Deutsch Arztebl Int 114: 273–279
Klemm E, Petz R, Freigang B (1983) Der Gebissschaden, ein endoskopischer Unfall? HNO-Praxis 8: 295–300
Klemm E, Künstle TH, Graf A, Henker M (1999) Tracheotomie, kritische Anmerkungen und Schlussfolgerungen. Intensivmed 36: 309–313
Klemm E, Henker M, Mürbe B (2000) Percutaneous and surgical tracheotomy: discussion of risks in various procedures. Laryngo-Rhino-Otol (Suppl 1) 79: 148
Knipping S, Schmidt A, Bartel-Friedrich S (2016) Der Einsatz der perkutanen Dilatationstracheotomie im Rahmen der Kopf-Hals-Tumorchirurgie. Laryngorhinotologie 95 (1): 29–36
Koitschev A, Graumüller S, Dommerich ST, Koitschev CH, Simon C (2003) Die Tracheotomie in der Intensivmedizin. Wird der HNO-Arzt noch gebraucht? HNO 51: 616–621
Kost KM (2005) Endoscopic percutaneous dilatational tracheotomy: a prospective evaluation of 500 consecutive cases. Laryngoscope (Suppl) 115: 1–30
Law RA, Carney AS, Manara AR (1997) Long-term outcome after percutaneous dilatational tracheostomy. Anaesthesia 52: 51–56
Leitlinie Tracheo-Bronchoskopie. AWMF online Register Nr. 017/061, Stand 07/2015. http://www.awmf.org/uploads/tx_szleitlinien/017-061l_S1_Tracheo_Bronchoskopie_2015-07.pdf
Lopez-Pastorini A, Kraja O, Ludwig C, Plönes T, Storre JH, Rommel T, Riecker A, Stoelben E (2015) Reduktion Tracheostoma-assoziierter Trachealstenosen durch chirurgischen Stomaverschluss. Pneumologie 69: 335–340
Massick D, Yao S, Powell D et al. (2001) Bedside tracheostomy in the intensive care unit: a prospective randomized trial comparing surgical tracheostomy with endoscopically percutanous dilational tracheotomy. Laryngoscope 111: 494–500
McCague A, Aljanabi H, Wong DT (2012) Safety analysis of percutaneous dilatational tracheostomies with bronchoscopy in the obese patient. Laryngoscope 122: 1031–1034
Muhammad JK, Major E, Wood A, Patton D (2000) Percutaneous dilatational tracheostomy: haemorrhagic complication and the vascular anatomy of the anterior neck. A review on 497 cases. Int J Oral Maxillofac Surg 29: 217–222
Nicolli EA, Carey RM, Farquhar D, Haft S, Alfonso KP, Mirza N (2017) Risk factors for adult acquired subglottic stenosis. JLO 131: 264–267
Norwood S, Vallina V, Short K, Saigusa M, Fernandez L, Mc Larty J (2000) Incidence of tracheal stenosis and other late complications after percutaneous tracheostomy. Ann Surg 232: 233–241
Nowak A, Klemm E (2011) Percutaneous dilatational tracheotomy using the tracheotomy endoscope. Laryngoscope 121: 1490–1494
Nowak A, Klemm E, Rothe KF (2007) Use of a tracheotomy-endoscope for percutaneous dilatational tracheostomy, results of a pilot study. Anesthesiology 107: A961
Nowak A, Kern P, Koscielny S, Usichenko TI, Hahnenkamp A, Jungehülsing M, Tittel M, Oeken J, Klemm E (2017) Feasibility and safety of dilatational tracheotomy using the rigid endoscope: a multicenter study. BMC Anesthesiol 17 (1): 7. https://doi.org/10.1186/s12871-017-0301-y
Oeken J, Adam H, Bootz F (2002) Translaryngeale Tracheotomie (TLT) nach Fantoni mit starrer endoskopischer Kontrolle. HNO 50: 638–643
Oggiano M, Ewig S, Hecker E (2014) A comparison of percutaneous dilatational tracheostomy versus conventional surgical tracheostomy. Retrospective study in 378 patients 2003–2008. Pneumologie 68: 322–328
Oreadi D, Carlson ER (2012) Morbidity and mortality associated with tracheotomy procedure in a university medical centre. Int J Oral Maxillofac Surg 41: 974–977
Paez M, Buisan F, Almaraz A, Martinez-Martinez A, Munoz F (2005) Percutaneous tracheotomy with the Ciaglia Blue Rhino technique: a critical analysis after 1 year. Rev Esp Anestesiol Reanim 52 (8): 466–73
Pilarczyk K, Haake N, Dudasova M, Huschens B, Wendt D, Demircioglu E, Jakob H, Dusse F (2016) Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis. Anaesth Intensive Care 44: 227–236
Remacle M, Lawson G, Jamart J, Trussart C, Bulpa P (2008) Comparison between the Percutwist® and the Ciaglia® percutaneous tracheotomy techniques. Eur Arch Otorhinolaryngol 265: 1515–1519
Rieger A (2006) Tracheotomie unter Einsatz der Intubationslarynxmaske. J An Ints 13: 51–54
Rosenbower T, Morris J, Eddy V, Ries W (1998) The long-term complications of percutaneous dilatational tracheostomy. Am Surg 64: 82–86
Shlugman D, Satya-Krishna R, Loh R (2003) Acute fatal haemorrhage during percutaneous dilatational tracheostomy. BJA 90: 517–520
Straetmans J, Schlöndorff G, Herzhoff G, Windfuhr JP, Kremer B (2010) Complications of midline-open tracheotomy in adults. Laryngoscope 120: 84–92
Terragni PP, Antonelli M, Fumagalli R et al. (2010) Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA 303 (15): 1483–1489
Trottier SJ, Hazard PB, Sakabu SA et al. (1999) Posterior tracheal wall perforation during percutaneous dilational tracheostomy: an investigation into its mechanism and prevention. Chest 115: 1383–1389
Trouillet JL, Luyt CE, Guiguet M, Quattara A, Vaissier E, Makri R et al. (2011) Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery. Ann Intern Med 154: 373–383
Walz MK, Peitken K, Thürauf N, Trost HA, Wolfhard U, Sander A, Ahmadi C, Eigler FW (1998) Percutaneous dilatational tracheostomy-early results and long-term outcome of 326 critically ill patients. Intensive Care Med 24: 685–690
Walz MK, Schmidt U (1999) Tracheal lesion caused by percutaneous dilatational tracheostomy – a clinico-pathological study. Intensive Care Med 25: 102–105
Young E, Pugh R, Hanlon R, O’Callaghans E, Wright C, Jeanrenaud P, Jones TM, Dempsey GA (2014) Trachealstenosis following percutaneos dilatational tracheostomy using the single tapered dilator: an MRI study. Anaesth Intensive Care 42 (6): 745–751
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Klemm, E., Nowak, A. (2018). Komplikationen der Tracheotomie und Strategien zu deren Vermeidung. In: Klemm, E., Nowak, A. (eds) Kompendium Tracheotomie und Atemwege . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56824-8_10
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