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Related Experiment Videos

Percutaneous dilational tracheostomy for airway control

E H Carrillo1, D A Spain, J M Bumpous

  • 1Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.

American Journal of Surgery
|November 28, 1997
PubMed
Summary

Endoscopic percutaneous dilational tracheostomy (PDT) offers a safe and effective method for long-term airway control in critically ill trauma patients, with no significant complications and reduced costs compared to surgical tracheostomy.

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Area of Science:

  • Critical Care Medicine
  • Surgical Procedures
  • Trauma Management

Background:

  • Percutaneous dilational tracheostomy (PDT) is an established endoscopic technique for airway management.
  • It offers a safe alternative with minimal morbidity and mortality for long-term airway control.

Purpose of the Study:

  • To evaluate the safety and efficacy of early endoscopic PDT in critically ill trauma patients.
  • To compare PDT with traditional surgical tracheostomy (ST) in terms of outcomes and cost.

Main Methods:

  • A prospective study of 35 intensive care unit (ICU) trauma patients requiring long-term airway control.
  • Early PDT was performed with bronchoscopic guidance, with conversion to ST if necessary.
  • Patient data including Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) were recorded.

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Main Results:

  • The average ISS was 29, with PDT placed 8 days post-ICU admission.
  • No significant complications were observed with PDT; two deaths occurred, unrelated to the procedure.
  • Endoscopic PDT reduced charges by $1,750 compared to ST.

Conclusions:

  • Bedside endoscopic PDT is a safe and effective alternative to ST for selected critically ill trauma patients.
  • The low complication rate supports the use of PDT at the bedside in the ICU.