A CLINICAL STUDY OF THE EFFECT OF TRACHEOSTOMY ON TRACHEOBRONCHIAL TREE AND LUNGS.

Tracheostomy refers to the surgical creation of a stoma into the trachea through neck to maintain airway. This study concentrates on the effect on tracheostomy on the tracheal secretions in both intubated and non-intubated patients.

The aim was to study the effect of tracheostomy on the organisms on the tracheal secretions, on color,consistency, and quantity of tracheal secretions and the effect on the tracheobronchial tree and lungs.

The study was conducted on a sample size of 60 patients with two groups of 30 each- intubated and non-intubated. The selected patients underwent a few investigations. Detailed examination of patient was performed. The patients after undergoing tracheostomy were examined on Day 2 and follow up was done at first and third month  or as long as the patient lived. During each follow up, patient was assessed concentrating mainly on the tracheal secretions like the color, quantity and consistency along with investigations like culture and sensitivity of tracheal aspirate, and chest X-ray. Patients were also assessed for any complications and documented.

The most common organism cultured on immediate follow up was Pseudomonas and Klebsiella in intubated & non-intubated patients respectively. Almost 90% patients in both groups yielded growth immediately post tracheostomy. The amount of tracheal secretion was profuse immediately after tracheostomy which gradually reduced to scanty during the three months of follow up. The growth pattern in the secretions did not significantly influence the development of chest complications. Intubation prior to tracheostomy was not a significant risk factor for the development of chest complications.

Endotracheal intubation prior to the procedure of open surgical tracheostomy does not significantly make a difference in the quantity and consistency of the tracheal secretion. Tracheal secretions were 90% infective in the immediate post tracheostomy period which became non infective through the first and third month of follow up. Tracheostomy didn’t have any effect on the chest pathology in both intubated and non-intubated patients.