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Hospital a Domicilio

On-line version ISSN 2530-5115

Abstract

FREIRE-FIGUEROA, Francisco et al. Description and management of the tracheostomy patient in Hospital at Home: experience in the Doctor Sótero del Río Care Complex. Hosp. domic. [online]. 2022, vol.6, n.2, pp.67-78.  Epub July 11, 2022. ISSN 2530-5115.  https://dx.doi.org/10.22585/hospdomic.v6i2.154.

Introduction.

Tracheostomy (TQT) is one of the oldest and most frequent procedures performed in critically ill patients. About 1 in 10 patients with mechanical ventilation support will require a TQT, with clinical management in hospital at home (HAH) being very similar to that reported in the in-hospital literature.

Methods.

Retrospective descriptive study of tracheostomized patients admitted to hospital at home Unit of Dr. Sótero del Río Care Complex from January 2016 to April 2020. The statistical program IBM SPSS 24 was used for data analysis.

Results:

A total of 96 tracheostomized patients entered the study, with a median of 64.5 (min. 16; max. 88) years of age, the main reason for admission to HAH was treatment of acute respiratory diseases (41.7%); the main reasons why these patients had TQT was due to neurological pathologies and due to prolonged mechanical ventilation (40.6%). The median used of TQT prior to admission to HD was 90 (min. 2; max. 3960) days and the median stay on HD was 22 (min. 2; max. 150) days. In 87 (90.6%) users the objective of tracheostomy management and education was set, and in 9 (9.3%) rehabilitation for decannulation; succeeding in 8 (88.8%) of them. In relation to its management, it was based on general TQT and stoma care, education, emergency management and decannulation.

Conclusion:

The multidisciplinary approach of tracheostomized patients on HAH is important under the guidelines of protocols and minimum standards of care, being able to perform procedures that were previously believed exclusive to in-hospital care (decannulation and cannula changes). This could be a viable alternative for decreasing hospital stay and optimize bed resource management.

Keywords : Tracheostomy; Home Care Services; Home Care Services, Hospital-Based; Rehabilitation.

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