Percutaneous dilational tracheostomy: an initial experience in community based teaching hospital

Area of Science:

• Critical Care Medicine
• Surgical Procedures
• Respiratory Care

Background:

• Prolonged endotracheal intubation in intensive care units (ICUs) can lead to long-term complications.
• Percutaneous dilational tracheostomy (PDT) is a common intervention to mitigate these risks.

Purpose of the Study:

• To analyze the clinical experience and outcomes of percutaneous dilational tracheostomy.
• To evaluate the safety and efficacy of PDT in a multidisciplinary ICU setting.

Main Methods:

• Prospective documentation of 40 patients undergoing PDT over a 12-month period.
• Data collected included patient demographics, indications for intubation and PDT, procedure duration, complications, and patient outcomes.
• Analysis of patient data within a multidisciplinary intensive care unit.

Main Results:

• 40 patients (22 female, 18 male, median age 35) underwent PDT, most commonly for prolonged ventilatory support after an average of 5 days of intubation.
• The median procedure time was 20 minutes. Complications were generally minor, including bleeding (5%), subcutaneous emphysema with pneumothorax (5%), and tracheal stenosis (7.5%).
• Of the 40 patients, 70% were discharged to the ward, 20% died in the ICU, and 10% left against medical advice.

Conclusions:

• Percutaneous dilational tracheostomy is a safe, rapid, and effective procedure for airway management in critically ill patients.
• PDT demonstrates a favorable risk-benefit profile for patients requiring extended mechanical ventilation.
• The study supports PDT as a valuable tool in intensive care settings.