Percutaneous dilatational tracheostomy versus conventional surgical tracheostomy. A clinical randomised study

Area of Science:

• Medical Procedures
• Surgical Techniques
• Critical Care

Background:

• No prior randomized clinical studies compared Ciaglia Percutaneous Dilatational Tracheostomy (PDT) with conventional surgical tracheostomy (TR).
• A study was designed to compare the efficacy and safety of PDT versus TR.

Purpose of the Study:

• To compare the efficacy and safety of percutaneous dilatational tracheostomy (PDT) using the Ciaglia Introducer Set against conventional surgical tracheostomy (TR).

Main Methods:

• Sixty patients undergoing elective tracheostomy were randomized to either PDT (30 patients) or TR (30 patients).
• All procedures were performed under general anesthesia with 100% oxygen ventilation.
• Local analgesia and bleeding minimization were achieved using lidocaine with epinephrine.

Main Results:

• PDT insertion time was significantly shorter (11.5 min) than TR (15 min) (P<0.01).
• PDT had fewer procedural complications, including significantly less minor bleeding (6 vs. 24 cases, P<0.01) and major bleeding (0 vs. 2 cases).
• Post-procedure, PDT showed significantly fewer minor infections (3 vs. 11 cases, P<0.01) and major infections (0 vs. 8 cases, P<0.01) compared to TR.

Conclusions:

• Percutaneous dilatational tracheostomy with the Ciaglia Introducer Set is effective and safe.
• PDT demonstrates superiority over conventional surgical tracheostomy.
• PDT is associated with fewer and less severe immediate and in-situ tracheostomy complications.