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Percutaneous tracheostomy: a comprehensive review
Ashraf O Rashid1, Shaheen Islam1
1Interventional Pulmonology, Division of Pulmonary Allergy, Critical Care & Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Journal of Thoracic Disease
|December 8, 2017
Summary
Percutaneous tracheostomy (PT) is a safe and effective procedure, even in complex patients. This method offers a lower complication rate and is cost-effective compared to traditional surgical tracheostomy.
Area of Science:
- Medicine
- Surgery
- Intensive Care Medicine
Background:
- Tracheostomy is a common procedure for airway management.
- Percutaneous tracheostomy (PT) is increasingly performed in intensive care units (ICUs) worldwide.
- Historically, certain conditions were considered contraindications for PT, but recent data challenge this.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous tracheostomy (PT).
- To assess the utility of adjuncts like ultrasound and bronchoscopy in PT procedures.
- To review the complication rates and cost-effectiveness of PT.
Main Methods:
- Review of current literature and clinical practices regarding percutaneous tracheostomy.
- Discussion of the role of ultrasound and bronchoscopy in guiding PT.
- Analysis of safety data in patient populations with previously considered contraindications.
Main Results:
- PT is safe and effective in patients with obesity, coagulopathy, and high ventilator demand.
- Ultrasound aids in anatomical identification, and bronchoscopy can reduce procedure time and complications.
- PT demonstrates a favorable complication rate, lower infection risk, and cost-effectiveness.
Conclusions:
- Percutaneous tracheostomy is a viable and safe alternative to surgical tracheostomy across a broad patient spectrum.
- Careful planning and operator experience are crucial for minimizing potential complications.
- PT offers significant advantages in terms of efficiency, safety, and cost.
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