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Introduction An Intensive Care Unit (ICU) is an area where critically ill patients are admitted and the highest level of care is provided with close intensive monitoring and management. Clinical audit is a must to measure indicators of the quality of care in ICU and benchmarking outcome. The main aim of the study was to evaluate the profile of patients admitted to ICU and assess their outcome of two consecutive years. Methods A single-institutional, descriptive cross-sectional study was conducted on all adult patients admitted to the ICU of Tribhuvan University Teaching Hospital, Kathmandu, between April 2018 and April 2020 (Baisakh 2075 to Chaitra 2076). Results With an average of 1.98 admissions per day, a total of 1447 patients were admitted to TUTH ICU over the period of two years. A male preponderance was noted with a male to female ratio of 1.19:1. Most of the patients admitted were neurosurgical cases 429 (29.6%). A total of 884 (61%) were shifted out of ICU in stable condition while the overall mortality was 458 (31.6%). Conclusion This study shows that there is a higher severity of illness at admission as well as a comparatively high mortality rate. More number of patients were male, of age group of 15-65 years, with medical and neurosurgical conditions. This study of profile and outcome of patients admitted in ICU can serve as a quality indicator as well as evidence on which planning and policymaking can be based upon in the future. [ABSTRACT FROM AUTHOR]

Introduction Tracheostomy is one of the frequent surgical procedure carried out in intensive care unit. Percutaneous tracheostomy is becoming increasingly popular compared to conventional open surgical tracheostomy in ICU. Methods A prospective randomized trial with twenty patients in each group was conducted to compare the outcomes of percutaneous and surgical tracheostomy. Percutaneous tracheostomy was performed using Ciaglia Blue Rhino technique and surgical tracheostomy was performed using established technique. The outcomes were compared in relation to randomization to tracheostomy, completion of procedure, intra operative and post-operative complications, hospital length of stay and cost. Results There were no major complications in either group. Most variables studied were not statistically significant. The two groups did not differ in terms of basic demographics or APACHE II score. The only variables to reach statistical significance were time duration from tracheostomy randomization to start of procedure and time taken for completion of procedure. It was mean 31.85±15.35 hours in Percutaneous Tracheostomy group and in Surgical Tracheostomy group it was mean 49.10±23.61 hours respectively (p<0.009). Time taken to perform percutaneous tracheostomy was mean 15.50±3.22 minutes and for surgical tracheostomy it was mean 20.30±3.38 minutes. (p<0.001). Conclusion Percutaneous dilatational tracheostomy is simple, faster to perform and can be done at bedside to avoid considerable delay in the performance of open tracheostomy where there is high demand for elective and emergency procedures in operating room. [ABSTRACT FROM AUTHOR]