Ulinastatin treatment was associated with improved outcomes in patients with severe acute pancreatitis.

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Percutaneous tracheostomy (PCT) is emerging as a popular method to secure a definitive airway in ventilated patients in critical care units as an alternative to surgical tracheostomy. It offers several advantages such as ease of performance, small skin incision, less tissue trauma, lower infection rate, bedside conduct as well as optimum utilization of ICU personnel. 1,2 The scope of PCT is increasing with training and experience, with successful management of more and more scenarios which were earlier perceived as contra indications. The present study was taken up with the objectives to evaluate safety of PCT in patients with difficult anatomy, bleeding diathesis and high ventilatory requirement, which are described as relative contra indications. We also intended to assess the complication rate and determine average time required.