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A single-center 8-year experience with percutaneous dilational tracheostomy
P A Kearney1, M M Griffen, J B Ochoa
1University of Kentucky Medical Center, Department of Surgery, Division of General Surgery, Section of Trauma/Critical Care, Lexington, Kentucky 40536, USA. Pakear0@pop.uky.edu
Annals of Surgery
|April 18, 2000
Summary
Percutaneous dilational tracheostomy (PDT) is a safe and effective procedure for intubated patients requiring elective tracheostomy. This study found low complication rates, including 1.6% tracheal stenosis, supporting PDT as an alternative to open tracheostomy.
Area of Science:
- Critical Care Medicine
- Surgical Procedures
- Respiratory Therapy
Background:
- Open tracheostomy carries risks for critically ill patients due to transport and suboptimal conditions.
- Percutaneous dilational tracheostomy (PDT) offers an alternative to open tracheostomy.
- Concerns exist regarding the completeness of complication data for PDT.
Purpose of the Study:
- To evaluate surgical, postoperative, and postdischarge complications of PDT.
- To assess the safety and efficacy of PDT over an 8-year period.
- To provide comprehensive complication data for PDT.
Main Methods:
- Prospective database of 827 PDTs from 1990-1998.
- Data collected on indications, procedure time, intubation duration, and complications.
- Retrospective chart review and phone interviews for long-term follow-up.
Main Results:
- Mean procedure time was 15 minutes; average intubation duration was 10 days.
- Intraoperative complication rate was 6% (premature extubation most common).
- Postoperative bleeding occurred in 5%; tracheal stenosis rate was 1.6% after >1 year follow-up.
Conclusions:
- PDT is a safe and effective alternative to open surgical tracheostomy.
- Experienced surgeons performing PDT achieve favorable outcomes.
- The study supports PDT for intubated patients needing elective tracheostomy.