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Related Experiment Videos

Percutaneous tracheostomy.

L I Worthley1, A W Holt

  • 1Department of Critical Care Medicine, Flinders Medical Centre, Adelaide, South Australia. lindsay.worthley@flinders.edu.au

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|April 8, 2006
PubMed
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Percutaneous tracheostomy is preferred over surgical tracheostomy for critically ill patients. This bedside procedure offers a smaller scar and potentially fewer complications, making it the method of choice.

Area of Science:

  • Critical Care Medicine
  • Surgical Procedures
  • Respiratory Management

Background:

  • Tracheostomy is frequently performed in critically ill patients requiring prolonged airway access, protection, and mechanical ventilation.
  • Percutaneous dilatational tracheostomy is increasingly utilized due to its rapid bedside performance compared to standard surgical techniques.

Purpose of the Study:

  • To compare the indications and complications of percutaneous tracheostomy versus standard surgical tracheostomy in critically ill patients.

Main Methods:

  • A comprehensive literature review of studies published between 1966 and 1998.
  • MEDLINE database search focused on percutaneous tracheostomy procedures.

Main Results:

  • Common percutaneous techniques include progressive dilatational and guidewire dilational forceps.

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  • Potential complications encompass needle/wire/dilator misplacement, insertion failure, tracheal ring fracture, bleeding, barotrauma, bacteremia, and mortality.
  • Bronchoscopic guidance can reduce complications but may prolong the procedure and cause hypercapnia.

    • Conclusions:

    • Percutaneous tracheostomy is the preferred method for critically ill patients needing tracheostomy.
    • Advantages include bedside performance, a smaller scar post-decannulation, and potentially fewer complications than surgical tracheostomy.