Tracheostomy in the Morbidly Obese: Difficulties and Challenges

Publication date: Available online 30 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Tirbod Fattahi, Christopher Chafin, Anthony Bunnell
PurposeThis manuscript is designed to evaluate the difficulties and challenges associated with open trachesotomy in the morbidly obese patient (BMI≥ 30 kg/m²).Patients & MethodForty patients met all the inclusion criteria. A retrospective chart review was then performed to evaluate indications for tracheostomy, length of intubation prior to tracheostomy, history of previous tracheostomy, length of operative procedure, length of time in the operating room, as well as all perioperative complications.ResultsComplications were classified as intra-operative (5%) and post-operative (17.5%). The average BMI of our patients was 46 kg/m² with a range of 31.1 to 75.3 kg/m². The average length of intubation prior to tracheostomy was 11 days. Ten patients (25%) had undergone a previous tracheostomy. The average operating time was 60 minutes with a range of 20-95 minutes. The average total time in the operating room was 100 minutes with a range of 45-146 minutes.ConclusionOur study shows that while open tracheostomy in the morbidly obese patient is increasing in demand, the procedure can be predictably performed albeit at a much longer duration and a higher peri-operative complication rate compared to the traditional tracheostomy.



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