Elective percutaneous (Rapitrac) tracheotomy: results of a prospective trial

A prospective trial was carried out to assess the incidence of complications from percutaneous tracheotomies by the Rapitrac method performed by one member of an otolaryngology unit and to compare them to the dissection method over the same time period. The first 32 patients had a Rapitrac carried out blindly. Three had paratracheal or anterior tracheal insertions, one of which resulted in death of the patient. The procedure was aborted in 5 patients (16%) because of difficulty introducing the curved needle. Primary hemorrhage, damage to the posterior wall, and surgical emphysema occurred in 2 (6%) patients each. Because of the high rate of complications due to the blind nature of the procedure, the following 23 procedures were carried out using a fiberoptic bronchoscope inserted through the endotracheal tube. This procedure resulted in only 2 minor complications and is recommended if the Rapitrac technique of percutaneous tracheotomy is the method of choice.