Related Experiment Videos
Percutaneous dilational tracheostomy or conventional surgical tracheostomy?
M Heikkinen1, P Aarnio, J Hannukainen
1Department of Surgery, Satakunta Central Hospital, Pori, Finland.
Critical Care Medicine
|June 2, 2000
Summary
Percutaneous dilational tracheostomy (PDT) is a cost-effective and safe procedure for intensive care unit (ICU) patients. This bedside method offers a simpler alternative to surgical tracheostomy (ST) with fewer complications.
Area of Science:
- Critical Care Medicine
- Surgical Procedures
- Health Economics
Background:
- Percutaneous dilational tracheostomy (PDT) is increasingly utilized in intensive care units (ICUs).
- PDT is associated with a low incidence of complications.
- Conventional surgical tracheostomy (ST) is an alternative procedure.
Purpose of the Study:
- To compare the costs, complications, and time consumption of PDT versus ST.
- To evaluate the efficacy and safety of bedside tracheostomy procedures in the ICU.
Main Methods:
- A prospective, randomized trial was conducted.
- 30 patients underwent PDT and 26 patients underwent ST at the bedside in the ICU.
- The Portex percutaneous tracheostomy kit was used for all PDTs.
Main Results:
- PDT took a mean of 11 minutes, while ST took a mean of 14 minutes.
- PDT had a mean cost of $161, significantly lower than ST's mean cost of $357 (p < .001).
- Bleeding complications were managed effectively in the PDT group; ST had no intraprocedural complications but one postoperative bleeding case.
Conclusions:
- PDT is a cost-effective and simple procedure for critically ill ICU patients.
- PDT is a safe alternative to ST when performed at the bedside in the ICU.
- Performing tracheostomies in the ICU avoids risks associated with transporting critically ill patients.