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Chawla's modified Griggs percutaneous tracheostomy: A safe, cost-effective alternative for resource-limited intensive
Vikas Chawla1, Siddharth Goyal1, Gopichand Reddy Yarkareddy1
1Department of Anaesthesiology and Critical Care, Johal Multi-Speciality Hospital, Jalandhar, Punjab, India.
Objective:
Percutaneous tracheostomy (PCT) offers advantages over surgical tracheostomy but remains underutilized in resource-limited settings due to dependence on bronchoscopy and costly commercial kits. Therefore, we conducted a retrospective study to evaluate the role of Chawla's modified Griggs PCT to overcome these barriers by eliminating bronchoscopy while maintaining safety.
Methods:
This retrospective study analyzed 72 intensive care unit patients undergoing modified PCT (2021-2023) using sterilized reusable instruments and low-cost disposables. Outcomes included success rates, complications, procedure time, and cost savings versus commercial kits.
Results:
The technique achieved 100% success with a mean procedure time of 6.2 ± 2.1 min. Only 3 cases (4.2%) had minor bleeding, with no major complications. Notably effective in 46 traumatic brain injury patients (63.9%), it reduced costs by 75%-85%. No delayed complications emerged at the 6-8 week follow-up.
Conclusion:
This modification demonstrates PCT can be performed safely and cost-effectively without bronchoscopy in resource-limited settings. The substantial cost savings and good outcomes in high-risk patients suggest strong potential for wider adoption in low- and middle-income countries, though prospective multicenter validation is needed.
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