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Clinical experience with percutaneous dilatational tracheostomy: report of 150 cases
L W van Heurn1, G J van Geffen, P R Brink
1Surgical Unit, De Wever Hospital, Heerlen, The Netherlands.
Objective:
To report our experience with percutaneous dilatational tracheostomy.
Design:
Retrospective study.
Setting:
Teaching hospital. The Netherlands.
Subjects:
147 patients.
Interventions:
150 percutaneous dilatational tracheostomies, 95 (63%) for prolonged ventilation, 37 (25%) for pulmonary toilet, and 18 (12%) for upper airway obstruction.
Main Outcome Measures:
Morbidity and mortality.
Results:
The success rate of the procedure was 99%. Operative complications occurred in 16 (11%) and were usually minor. During a total duration of cannulation of 5212 days four complications were recorded. Haemorrhage was the most common early complication (n = 14). Late complications (five to 53 months after decannulation) included tracheal stenosis (n = 1), tracheomalacia (n = 2), tracheocutaneous fistula (n = 2) and an ugly scar (n = 1).
Conclusion:
Percutaneous dilatational tracheostomy is a simple, safe and cost effective technique for inserting a tracheal cannula.