Percutaneous dilatational versus conventional open tracheotomy in a growing animal: a study in goats

Percutaneous dilatational tracheotomy (PDT) is a new technique for the introduction of a tracheal cannula. It has been performed successfully in adults; however, in children, the open conventional technique is preferred because of the technical limitations of PDT, with fear of tracheal stenosis and adverse effects on tracheal growth. The authors studied the applicability of PDT in a growing animal. Two groups of goat kids (aged 10 days) underwent PDT or conventional open tracheotomy. They were cannulated for 7 days. Three months after decannulation, the tracheas were analyzed macroscopically and microscopically. The coronal (lateral) diameter and the cross-sectional area at the level of the stoma were 4.7 mm (SEM, 0.23 mm) and 41 mm2 (SEM, 3.0 mm2) after open tracheotomy, versus 8.1 mm (SEM, 0.13 mm) and 58 mm2 (SEM, 4.6 mm2) after PDT (P < .001 and P = .023, respectively). The quotient of the stomal cross-sectional area and the normal cross-sectional area was significantly smaller after open tracheotomy than after PDT (P < .001), with a cross-sectional area reduction of 24% to 40% in the open group. The authors conclude that PDT can be performed in growing animals without an increased risk of tracheal stenosis and adverse effects on tracheal growth. They recommended that PDT be investigated in children in a clinical setting.