Post-operative sputum retention treated by minitracheostomy--a ward procedure?

Cricothyroidotomy, using the percutaneous 'minitracheotomy' technique, was performed in 67 patients (55 for sputum retention, two for endobronchial rupture of an empyema, 10 prophylactically). In two patients the cricothyroid membrane was penetrated with considerable difficulty, and in one further patient insertion was not possible due to calcification of the cricothyroid membrane. One patient required exploration of the insertion site because of bleeding. Two patients inhaled the 'Mark 1 Minitrach' device and required urgent bronchoscopic removal. In those patients undergoing successful cricothyroidotomy, there was a dramatic improvement in respiratory distress. There were no deaths related to the insertion of the minitracheotomy device in this series.