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[Percutaneous tracheostomy].

F Ravat1, C Pommier, R Dorne

  • 1Centre des brûlés, centre hospitalier Saint-Joseph et Saint-Luc, 9, rue professeur Grignard, 69007 Lyon, France. ravat@free.fr

Annales Francaises D'Anesthesie Et De Reanimation
|May 3, 2001
PubMed
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Percutaneous tracheostomy techniques offer comparable safety and feasibility to surgical methods, with potential advantages in late complications. Experienced operators using continuous endoscopic guidance enhance percutaneous tracheostomy safety.

Area of Science:

  • Critical Care Medicine
  • Surgical Techniques
  • Respiratory Management

Background:

  • Tracheostomy is a common procedure in intensive care units.
  • Percutaneous tracheostomy has gained popularity as an alternative to surgical tracheostomy.
  • Evaluating different percutaneous techniques is crucial for optimizing patient care.

Purpose of the Study:

  • To compare various percutaneous tracheostomy techniques with standard surgical tracheostomies.
  • To analyze the advantages, drawbacks, and complications of each method.
  • To assess elective bedside procedures in intensive care settings.

Main Methods:

  • Systematic literature review of Medline and major review articles.
  • Selection of articles based on evidence level, focusing on the last five years.

Related Experiment Videos

  • Data extraction on techniques, perioperative/postoperative complications, and recent comparisons.

    • Main Results:

    • Four marketed percutaneous techniques exist: Ciaglia, Griggs, and Fantoni.
    • No technique demonstrates clear superiority in feasibility or safety over others.
    • Percutaneous tracheostomy may have fewer late complications, while surgical tracheostomy may have fewer perioperative complications.
    • Operator experience and continuous endoscopic guidance significantly improve percutaneous tracheostomy safety.

    Conclusions:

    • Percutaneous tracheostomy incidence is increasing in ICUs, with a trend to replace surgical procedures.
    • Potentially serious complications necessitate experienced operators and endoscopic guidance for percutaneous tracheostomy.
    • The choice of technique should consider operator expertise and patient factors.