A Clinical Study about the Effect of Tracheostomy in the Brain Damaged Patients.

Kim, Seong Ho; Kim, Youn

Original Article

Journal of Korean Neurosurgical Society 1985;14(1): 175-182.

Department of Neurosurgery, College of Medicine, Chungnam National University, Taejeon, Korea.

ABSTRACT

A tracheostomy is the safest and popular method for maintaining airway. Recently, this method is interesting in neurosurgical unit respiratory care in brain damaged patients. Authors had performed a tracheostomy on 20 cases among the brain damaged patients and evaluated it's effect by PaO2 and PaCO2 change, respiratory and Glasgow coma scale change between pretracheostomic and posttracheostomic state. Also, it's complications were evaluated. The results are as follows ; 1) After tracheostomy, significant elevations were noted in mean arterial oxygen tension from 65.55+/-19.34mmHg to 85.83+/-33.53mmHg at 30mins, to 84.48+/-29.12mmHg at 60mins, to 97.00+/-21.25mmHg at 120mins. 2) After tracheostomy, significant changes were not noted in mean arterial carbon dioxide tension. 3) After tracheostomy, progressive decrease in mean respiratory rate per min. were noted from 27.6+6.44 to 21.89+2.79 during 24hrs. 4) After tracheostpmy, slight improvement in mean Glasgow coma scale were noted from 7.7+2.54 to 8.25+2.95 during 24hrs. 5) The complications occured in 5 cases. 4 cases of them were pneumonias and 1 case of them was hemorrhage. From above results, Authors conclude that tracheostomy improves poor clinical status including hypoxemia and tachypnea which have influence on brain metabolism in the brain damaged patients.

Key Words: Tracheostomy; PaO2; PaCO2; Respiratory rate; Glasgow coma scale