Is minitracheotomy a simple and safe procedure? A prospective investigation in the intensive care unit

Patients with imminent respiratory failure due to sputum retention were assessed for minitracheotomy (MT). MT was considered potentially useful in 79 patients but only attempted in 73, 54 men and 19 women, aged 23-81 years (median 65 years). Insertion of the cannula failed in 4 cases. Sputum retention and atelectasis were successfully treated in 87% (N = 60). Treatment by MT in medical and neurological patients seems as effective as in surgical patients (success rate 81% versus 90%). The frequency of complications was 16%. Most complications were insignificant and occurred during cannulation, but a few severe complications were seen. To minimize the number of these it is essential that MT is done only by doctors who are familiar with the procedure. MT can be recommended for treatment of sputum retention and atelectasis in surgical and medical/neurological intensive care patients with preserved cough function.