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Related Experiment Videos

Open bedside tracheotomy in the intensive care unit.

S J Wang1, J A Sercarz, K E Blackwell

  • 1Division of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, USA.

The Laryngoscope
|June 16, 1999
PubMed
Summary

Open bedside tracheotomy is an efficient, safe, and cost-effective procedure. This method offers comparable safety to percutaneous tracheotomy at a significantly lower cost, making it a viable alternative for patient care.

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Area of Science:

  • Surgical Procedures
  • Critical Care Medicine
  • Health Economics

Background:

  • Tracheotomy is a common surgical procedure for airway management.
  • Traditional open tracheotomy is often performed in the operating room, incurring higher costs and resource utilization.
  • Percutaneous tracheotomy offers an alternative but may have specific indications and associated costs.

Purpose of the Study:

  • To evaluate the efficiency, safety, and cost-effectiveness of open bedside tracheotomy.
  • To compare open bedside tracheotomy with operating room and percutaneous techniques.

Main Methods:

  • Retrospective review of over 200 open bedside tracheotomies performed between 1995 and 1998.
  • Minimal staffing required: attending/senior resident, junior resident/intern, and respiratory therapist.

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  • Procedure duration averaged 15-25 minutes; patients followed for 30 days post-surgery.

    • Main Results:

    • Major complication rate (hemorrhage, myocardial infarction) <1%.
    • Minor complication rate (site bleeding) was 4%.
    • Overall 30-day mortality was 8% (unrelated to tracheotomy); procedure cost was $233, significantly less than OR ($3000+) or percutaneous ($1000+).

    Conclusions:

    • Open bedside tracheotomy is an efficient and economical alternative to operating room procedures.
    • The safety profile is comparable to percutaneous tracheotomy.
    • This technique offers significant cost savings without compromising patient safety.