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Review of percutaneous tracheostomy
D M Powell1, P D Price, L A Forrest
1Department of Otolaryngology, The Ohio State University, Columbus 43210-1282, USA.
The Laryngoscope
|February 24, 1998
Summary
Percutaneous tracheostomy methods vary in safety and efficacy. Percutaneous dilational tracheostomy (PDT) shows comparable complication rates to open surgery, but requires surgeon experience.
Area of Science:
- Medical procedures
- Surgical techniques
- Airway management
Background:
- Percutaneous tracheostomy offers an alternative to open tracheostomy.
- Four primary methods exist, with varying levels of investigation and reported outcomes.
Purpose of the Study:
- To compare the safety and efficacy of four percutaneous tracheostomy techniques.
- To analyze complication rates across different percutaneous tracheostomy methods.
Main Methods:
- Comprehensive literature review of 40 series, encompassing 1684 patients.
- Retrospective analysis of 22 patients undergoing percutaneous dilational tracheostomy (PDT).
Main Results:
- The Rapitrac method exhibited a high perioperative complication rate.
- Percutaneous dilational tracheostomy (PDT) demonstrated complication rates similar to open tracheostomy.
- A learning curve was identified for PDT, necessitating surgeon proficiency.
Conclusions:
- Percutaneous dilational tracheostomy (PDT) can be a safe and cost-effective option for select patients.
- Surgeon experience and preparation are crucial for safe implementation of PDT.
- Further investigation into less-studied methods like Toye and guide wire dilator forceps (GWDF) may be warranted.
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