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Bedside percutaneous tracheostomy: experience with 55 elective procedures
P B Hazard1, H E Garrett, J W Adams
1University of Tennessee Center for the Health Sciences, Memphis.
The Annals of Thoracic Surgery
|July 1, 1988
Summary
Percutaneous dilatational tracheostomy is a rapid, simple, and safe bedside procedure for critically ill patients. This wire-guided technique minimizes cosmetic deformity and infectious complications, making it suitable for routine use.
Area of Science:
- Critical Care Medicine
- Surgical Techniques
- Respiratory Therapy
Background:
- Tracheostomy is a common procedure for prolonged mechanical ventilation.
- Traditional surgical tracheostomy carries risks including bleeding and infection.
- Percutaneous techniques offer potential advantages in safety and cosmesis.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous dilatational tracheostomy (PDT).
- To assess the feasibility of PDT in an intensive care unit (ICU) setting.
- To identify modifications for optimizing the PDT procedure.
Main Methods:
- A 24-month prospective study of 55 patients undergoing PDT.
- Procedures performed at the bedside under local anesthesia.
- Utilized a wire-guided, dilatational technique with various devices, including a modified endotracheal tube.
Main Results:
- The percutaneous dilatational tracheostomy (PDT) technique was rapid and simple.
- No significant cosmetic deformity was observed.
- Infectious complications were virtually eliminated.
- The procedure was successfully performed in mechanically ventilated ICU patients.
Conclusions:
- Percutaneous dilatational tracheostomy (PDT) is a safe and effective method for airway management.
- PDT offers significant advantages over traditional tracheostomy, particularly in reducing complications.
- This technique is recommended for routine use in ventilator-dependent patients.