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Percutaneous tracheostomy--long-term outlook, a review
S Sviri1, P V van Heerden, R Samie
1Medical Intensive Care Unit, Hadassah Hospital, Jerusalem, Israel.
Summary
Percutaneous tracheostomy is a preferred bedside procedure for critically ill patients needing airway support. While short-term complications occur, it offers advantages over surgical methods, though long-term effects require further study.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Surgical Techniques
Background:
- Tracheostomy is essential for critically ill patients requiring prolonged mechanical ventilation, airway protection, and pulmonary toilet.
- It aids in weaning from ventilation, reduces laryngeal injury, and improves patient comfort, potentially decreasing sedation needs.
Purpose of the Study:
- To review percutaneous tracheostomy techniques.
- To evaluate the long-term complications associated with these techniques in critically ill patients.
Main Methods:
- A comprehensive review of studies reporting on various percutaneous tracheostomy techniques was conducted.
Main Results:
- Percutaneous dilatational tracheostomy is a rapid bedside procedure.
- Short-term complication rates range from 7-22%, including bleeding and pneumothorax, with peri-operative mortality at 0.2-0.7%.
- Long-term complication data are less defined.
Conclusions:
- Percutaneous tracheostomy is the preferred method for critically ill patients requiring tracheostomy.
- It offers advantages such as bedside performance, smaller scars, and potentially fewer complications than surgical tracheostomy.