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Percutaneous dilatational tracheostomy versus open tracheostomy--a prospective, randomized, controlled trial
Jackson Jer-Kan Wu1, Mu-Shun Huang, Gau-Jun Tang
1Division of Trauma, Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. jkwu@vghtpe.gov.tw
Journal of the Chinese Medical Association : JCMA
|November 8, 2003
Summary
Percutaneous dilatational tracheostomy (PDT) is a faster and equally safe alternative to open tracheotomy (OT) for elective procedures. This bedside technique is recommended for critical patients needing tracheostomy.
Area of Science:
- Critical Care Medicine
- Surgical Procedures
Background:
- Open tracheotomy (OT) is a common procedure, but its superiority over percutaneous dilatational tracheostomy (PDT) remains debated.
- PDT has gained popularity, necessitating a direct comparison with OT.
Purpose of the Study:
- To compare the procedure time, complication rates, safety, and cost-effectiveness of PDT versus OT.
- To evaluate the efficacy of the Ciaglia method for PDT.
Main Methods:
- A prospective randomized clinical trial was conducted in a university-based hospital's general Intensive Care Unit.
- Eighty-three patients requiring elective tracheostomies were randomized to either PDT (Ciaglia method) or OT.
- Data collected included operative details, complications, and mortality.
Main Results:
- PDT procedure time averaged 22.0 minutes, significantly shorter than OT's 41.5 minutes (p < 0.001).
- No significant differences in complication incidence were observed between the PDT and OT groups.
- Patient demographics (age, gender) and pre-tracheostomy intubation duration did not differ between groups.
Conclusions:
- Percutaneous dilatational tracheostomy is a simple, safe, and time-saving bedside procedure.
- PDT is a recommended alternative for elective tracheostomies in critical care settings.