Hubungan Lama Rawatan dan Lepas Ventilator pada Pasien Post Percutaneous Dilatation Tracheostomy (PDT) di Intensive Care Unit RSUP H Adam Malik Medan

Abstract

Background: Prolonged use of mechanical ventilation in critically ill patients is associated with long duration of intensive care unit (ICU) stay and long hospital stays and high mortality rates. Percutaneous Dilatation Tracheotomy (PDT) is a common invasive procedure performed on patients with respiratory problems who require mechanical ventilation to support respiratory function. PDT in the intensive care unit is a frequent intervention for patients who cannot be weaned from mechanical ventilation in hopes of getting off more quickly from mechanical ventilation and to reduce costs of care. Objective: This study was to examine the relationship between length of stay and ventilator discharge in postoperative patients percutaneous dilation tracheostomy (PDT) in the Intensive Care Unit (ICU) and know the description of post patient costs percutaneous dilation tracheostomy (PDT) performed on patients treated in ICU H. Adam Malik General Hospital Medan. Method: This research is a descriptive analysis research that describes the profile of tracheostomy patients. The research design used was a cross-sectional study. After obtaining approval from the Ethics Committee of the Faculty of Medicine, University of North Sumatra Medan, secondary data was collected from medical records in 2022. The sampling technique in this study was total sampling. The sample is the medical records of patients who have had a tracheostomy performed in 2022 at the Intensive Care Unit at the H. Adam Malik General Hospital Medan with the inclusion criteria of comorbid patients with lung infections, kidney failure, malignancy, gastrointestinal, cardiovascular and have undergone less or more tracheostomy. 14 days. Results: It was found that there was a relationship between length of stay and ventilator discharge in post percutaneous dilation tracheostomy (PDT) patients where p value 0.033 (p<0.05). Patients with a longer length of stay tend to require a longer time off the ventilator, while patients with a shorter length of stay have a shorter duration off the ventilator.The length of stay in the ICU ranged from 20.09 ± 6.36 days and off the ventilator in patients who had beenpost percutaneous dilatation tracheostomy (PDT) range 4±1.44 day. While the costs incurred for treatment vary in patients depending on the patient's condition, however, it was obtained from this study the costs during treatment in the ICU with patients after being given an action percutaneous dilation tracheostomy less than 14 days lower (Rp 28.977.863 ± Rp 14.022.631) than the patients who were performed percutaneous dilation tracheostomy more than 14 days (Rp 32.269.633 ± Rp 20.232.914). Conclusion: Percutaneous Dilation Tracheotomy (PDT) in patients < 14 days it is better for shorter duration off the ventilator, so that the length of stay in the ICU is shorter and reduces the cost of length of stay in the ICU.In addition, coordinated efforts and proper care must be put in place in order to speed up the patient's recovery.