A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy

Abstract

A prospective non-randomized study was undertaken to compare, in intensive care patients, the safety and utility of a percutaneous tracheostomy technique performed at the bedside with a surgical tracheostomy technique performed in the operating room. During a 21 month period, 153 percutaneous tracheostomies were performed. Complications occurred in 6 patients (3.9%). Secondary wound haemorrhage occurred in 4 patients and primary wound haemorrhage occurred in 2 patients. During the same period, 74 surgical tracheostomies were performed. Complications occurred in 14 patients (18.9%) which included tracheal obstruction, haemorrhage, pneumothorax, wound infection, wound breakdown and one death. In comparison to surgical tracheostomies, percutaneous tracheostomies were rapidly and easily performed at the bedside and were associated with significantly fewer complications.

A comparison of percutaneous and operative tracheostomies in intensive care patients

“…13,17 The aim of our study was to compare the complication rate and surgical conditions of conventional surgical and percutaneous dilational trachestomies performed under general anaesthesia in critically ill patients.…”

A comparative study of open tracheostomy and percutaneous tracheostomy in ICU setting

“…Though the incidence of complications with percutaneous tracheostomy varies with the different techniques used, it is fewer compared to open surgical technique [10]. Some authors have also suggested use of fiber optic bronchoscope to reduce th procedural complications.…”

Airway control via the Cobrapla™ during percutaneous dilatational tracheotomy in five patients

“…D Di is sc cu us ss si io on n PDT has become increasingly popular over performing a traditional surgical tracheostomy in recent years because of its relative ease and low cost, as well as having fewer complications. 1,10,11 However, because it is a blind technique (from the surgeon's perspective) one must have assurance that the needle, guide wire, dilator, and tracheostomy tube all reside within the trachea. In the simplest form, aspiration through the needle advancing into the trachea indicates entry into that airfilled structure.…”

“…Because of these limitations, continuous observation of the PDT via a FOB is used more and more frequently. 1 This is the only technique that can assure successful completion of each stage of the PDT. In addition, one can monitor for excessive bleeding or perforation of the posterior wall of the trachea.…”