Prolongated Intubation Patient Profile Conducted By Trakeostomy At ICU/Post Surgery At H. Adam Malik Hospital Medan 2017

Feb 27, 2025 by ADMIN 121 views

**Prolonged Intubation Patient Profile Conducted by Tracheostomy in ICU/Post Surgery at H. Adam Malik Hospital Medan in 2017**

Background

Understanding the Complexity of ICU Patients

Patients treated in the Intensive Care Unit (ICU) are individuals who require urgent medical interventions and the management of coordinated and sustainable body organs. Many patients with critical conditions require breathing aids and ventilation support to survive. Although non-invasive ventilation is recommended to avoid prolonged intubation, not all cases can be overcome by this method. Most patients with breathing failure ultimately still need intubation. Tracheostomy is one of the common procedures carried out in the ICU and has several medical indications, including airway obstruction, estimated use of mechanical ventilation for a long time, airway protection, increased patient comfort, and to facilitate development and improve patient safety.

Research Purposes

Unveiling the Profile of Prolonged Intubation Patients

This study aims to reveal the description of the profile of patients who experience prolonged intubation and then undergo tracheostomy procedures. Some variables to be analyzed include age, gender, time of implementation of tracheostomy, duration of treatment in hospitals, and the number of deaths that occur in these patients. By understanding the profile of these patients, healthcare providers can develop more effective strategies to manage their conditions and improve patient outcomes.

Method

Descriptive Study with Cross-Sectional Design

In this study, descriptive methods were used with cross-sectional design. Data was collected through the medical record of patients treated at H. Adam Malik Hospital Medan. Sampling was carried out with a total sampling technique, which allows data collection from all populations that meet the research criteria. This method ensures that the sample is representative of the population and provides a comprehensive understanding of the research topic.

Research Result

Demographic Characteristics of Prolonged Intubation Patients

The results showed that of a total of 84 patients who experienced prolonged intubation and undergoing tracheostomy, there was dominance in male patients as many as 45 people (54%). The majority of patients are elderly, with 56 people (67%) over 45 years old. The tracheostomy procedure is most widely performed in the first week, reaching 42 people (50%). In addition, the length of treatment in the most hospital is more than one month, with a total of 34 people (41%). Of the total patients, 49 people (58%) suffered death.

Analysis and Discussion

Understanding the Complexity of Prolonged Intubation Patients

From the results of this study, it appears that most patients undergoing tracheostomy at H. Adam Malik Hospital Medan are elderly men. This may be related to the high prevalence of respiratory and cardiovascular diseases in this age group, which often requires prolonged ventilation interventions. The time for the implementation of tracheostomy which is generally carried out in the first week indicates that the intervention is a step taken after prolonged intubation, which shows the need for more permanent airway management.

The duration of treatment for more than one month also reflects the complexity and difficulty in handling these patients. This can indicate that patients who are more severe or more complex require longer recovery time, and may also contribute to high mortality rates. The high mortality rate in this study, reaching 58%, is an important concern in clinical practice. This number may reflect the nature of the underlying disease, pre-existing health conditions, and the severity of respiratory disorders experienced by patients.

Conclusion

Implications for Clinical Practice

Based on the results of the study, it can be concluded that in H. Adam Malik Hospital Medan, patients undergoing tracheostomy after prolonged intubation are dominated by men and elderly people. The time for the implementation of tracheostomy that often occurs in the first week and a length of treatment of more than one month indicates the severity of the patient's condition is quite high. In addition, the mortality rate reached 58%, signifying a significant challenge in the management of patients with this condition. Further research is needed to explain the factors that contribute to clinical results in patients with prolonged intubation and tracheostomy.

Limitations of the Study

This study has several limitations that should be considered when interpreting the results. Firstly, the study was conducted in a single hospital, which may limit the generalizability of the findings to other hospitals. Secondly, the study only included patients who underwent tracheostomy, which may not be representative of all patients with prolonged intubation. Finally, the study did not control for potential confounding variables, which may have affected the results.

Future Research Directions

Despite the limitations of this study, it provides valuable insights into the profile of patients with prolonged intubation and tracheostomy. Future research should aim to replicate this study in other hospitals and settings to confirm the findings. Additionally, further research should investigate the factors that contribute to clinical results in patients with prolonged intubation and tracheostomy, such as the underlying disease, pre-existing health conditions, and the severity of respiratory disorders.

Clinical Implications

The findings of this study have several clinical implications. Firstly, healthcare providers should be aware of the high prevalence of respiratory and cardiovascular diseases in elderly men, which may require prolonged ventilation interventions. Secondly, healthcare providers should consider the need for more permanent airway management in patients with prolonged intubation. Finally, healthcare providers should be aware of the high mortality rate in patients with prolonged intubation and tracheostomy, and take steps to improve patient outcomes.

Conclusion

In conclusion, this study provides valuable insights into the profile of patients with prolonged intubation and tracheostomy. The findings suggest that most patients undergoing tracheostomy at H. Adam Malik Hospital Medan are elderly men, and that the time for the implementation of tracheostomy and the length of treatment are indicative of the severity of the patient's condition. The high mortality rate in this study is an important concern in clinical practice, and highlights the need for further research to explain the factors that contribute to clinical results in patients with prolonged intubation and tracheostomy.

Q: What is prolonged intubation?

A: Prolonged intubation refers to the use of an endotracheal tube for an extended period, typically more than 7-10 days. This can be due to various reasons, including respiratory failure, neurological disorders, or other critical conditions that require mechanical ventilation.

Q: What is tracheostomy?

A: Tracheostomy is a surgical procedure that involves creating an opening in the neck to insert a tube into the trachea (windpipe). This allows for more permanent airway management and can be used to facilitate breathing, speaking, and eating.

Q: What are the indications for tracheostomy?

A: Tracheostomy is indicated in various situations, including:

Airway obstruction
Estimated use of mechanical ventilation for a long time
Airway protection
Increased patient comfort
To facilitate development and improve patient safety

Q: What are the demographic characteristics of patients with prolonged intubation and tracheostomy?

A: The study found that most patients undergoing tracheostomy at H. Adam Malik Hospital Medan are elderly men, with 54% being male and 67% being over 45 years old.

Q: What is the time frame for implementing tracheostomy?

A: The study found that the tracheostomy procedure is most widely performed in the first week, with 50% of patients undergoing the procedure within this timeframe.

Q: What is the duration of treatment for patients with prolonged intubation and tracheostomy?

A: The study found that the length of treatment in the most hospital is more than one month, with 41% of patients requiring treatment for more than 30 days.

Q: What is the mortality rate for patients with prolonged intubation and tracheostomy?

A: The study found that the mortality rate for patients with prolonged intubation and tracheostomy is 58%, which is a significant concern in clinical practice.

Q: What are the implications of the study for clinical practice?

A: The study highlights the need for healthcare providers to be aware of the high prevalence of respiratory and cardiovascular diseases in elderly men, which may require prolonged ventilation interventions. Additionally, healthcare providers should consider the need for more permanent airway management in patients with prolonged intubation and take steps to improve patient outcomes.

Q: What are the limitations of the study?

A: The study has several limitations, including:

The study was conducted in a single hospital, which may limit the generalizability of the findings to other hospitals.
The study only included patients who underwent tracheostomy, which may not be representative of all patients with prolonged intubation.
The study did not control for potential confounding variables, which may have affected the results.

Q: What are the future research directions?

A: Future research should aim to replicate this study in other hospitals and settings to confirm the findings. Additionally, further research should investigate the factors that contribute to clinical results in patients with prolonged intubation and tracheostomy, such as the underlying disease, pre-existing health conditions, and the severity of respiratory disorders.

Q: What are the clinical implications of the study?

A: The study has several clinical implications, including:

Healthcare providers should be aware of the high prevalence of respiratory and cardiovascular diseases in elderly men, which may require prolonged ventilation interventions.
Healthcare providers should consider the need for more permanent airway management in patients with prolonged intubation.
Healthcare providers should be aware of the high mortality rate in patients with prolonged intubation and tracheostomy, and take steps to improve patient outcomes.