Percutaneous Dilational Tracheostomy

Hill, Bruce C.; Zweng, Thomas N.; Maley, Richard H.; Charash, William E.; Toursarkissian, Boulos; Kearney, Paul A.

doi:10.1097/00005373-199608000-00007

Cited by 161 publications

(124 citation statements)

References 31 publications

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“…Moreover, it adds complexity to the procedure and risks potential endoscope damage. Like other authors, we found endoscopic guidance useful during the learning phase [33,37] and in dif®cult patients. However, we do not recommend its routine use with the Griggs technique because the larger soft tissue stoma created by the forceps allows easier identi®cation of the tracheal level and the midline without additional blunt dissection [29,38].…”

Section: Discussionsupporting

confidence: 83%

“…Using endoscopic examination 3 months after removal of the tracheostomy tube, we found severe tracheal narrowing at the stoma site in 5% of the survivors and granulation tissue at the stoma site without the need for treatment in 9%. This compares favourably with stenosis rates of 0±5% in other series [40]. Rates of other complications are similar for percutaneous and open tracheostomy [41].…”

Section: Discussionsupporting

confidence: 70%

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Percutaneous tracheostomy by forceps dilation: report of 162 cases

et al. 2000

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SummaryA prospective, observational clinical study evaluated the safety of percutaneous single-step dilational tracheostomy over a 43-month period. One hundred and sixty-two patients were deemed suitable for the procedure. The mean duration of tracheal intubation prior to tracheostomy was 6 days. The mean duration of the procedure was 9.3 min. Intra-operative complications occurred in 27 patients (16.6%), most of which were minor technical dif®culties without morbidity. Postoperative complications, some of which were associated with morbidity, occurred in 16 patients. There were two deaths secondary to premature decannulation, one case of severe bleeding and ®ve pneumothoraces. Long-term complications were assessed in 81 patients; there were four tracheal stenoses requiring surgery or laser therapy and seven patients with granulation tissue at the stoma site which did not require treatment. Forceps dilatational percutaneous tracheostomy appeared to be a convenient bedside procedure. However, complications do occur and further studies should address late sequellae, such as tracheal stenosis.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 70%

Percutaneous tracheostomy by forceps dilation: report of 162 cases

et al. 2000

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“…The current preoperative intubation and postoperative observation times match results in international studies (Table I). [12][13][14]19,22,25 Also, the great variation in cannulation time is reflected in literature. 15,[20][21][22]25 In contrast to other studies, patients were not selected, and 88 (26.7%) high-risk patients, of whom 13 (4%) had acute dyspnea, were included in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Of all tracheotomies, 72.9% were performed in the first 3 weeks after endotracheal intubation (Table II). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] The period of cannulation varied strongly (range, 1-730 days) (n ¼ 291). In 146 patients (49.5%), the cannula remained in situ for a time period between 1 week and 1 month (20.3% 1-7 days and 25.3% 30-90 days).…”

Section: Clinical Time Intervalsmentioning

confidence: 99%

Complications of midline‐open tracheotomy in adults

et al. 2009

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Objectives/Hypothesis: Percutaneous tracheotomy is progressively replacing open tracheotomy as a consequence of promising results of comparative studies. However, this comparison has four considerable weaknesses: 1) selected indications (high-risk patients excluded for percutaneous tracheotomy); 2) varying spectra of complications included in different studies; 3) varying operative settings (experienced surgeons exclusively, surgeons in training, or both); and 4) missing differentiation between different surgical techniques. Our study was performed to collect complete datasets of unselected patients who all underwent a tracheotomy in a uniform technique in an academic teaching hospital setting.Methods: Retrospective evaluation of all complications following 303 consecutive surgical tracheotomies (midline-open technique) performed by different surgeons and surgeons in training at one academic institution. Complications were classified and compared to results in the literature.Results: Rates of 21.5% minor and 1.0% major complications and 0% tracheotomy-related mortality were registered. The most prevalent complications were local wound infections (10.9%), intra-and postoperative hemorrhages (4.2%), and cartilage damage (1.7%). No significant difference was found for highrisk patients and emergency tracheotomies.Conclusions: Our study demonstrates that open tracheotomy is a safe procedure, particularly if performed in high-risk patients even by inexperienced surgeons. Therefore, we emphasize the advantages of the midline-open tracheotomy in an academic teaching hospital setting.

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“…It was introduced as a preferred, safe and less-invasive bedside method that is alternative for open surgical tracheostomy. The rate of overall perioperative complications is 19% 3 . Although adverse events are relatively uncommon, serious life threatening complications can arise from this bedside procedure.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Pneumothorax as a Complication of Percutaneous Tracheostomy: Case Report

Klancir¹,

Adam

Mršić³

et al. 2016

ACC

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SUMMARY -Percutaneous dilatational tracheostomy is a common surgical procedure that is becoming the method of choice in critically ill patients whenever prolonged airway secure and/ or ventilation support is needed. Although adverse events are relatively uncommon, serious life threatening complications can arise from this bedside procedure. We report a case of a 70-year-old female who developed extensive subcutaneous emphysema and bilateral pneumothorax immediately after a percutaneous dilatational tracheostomy procedure. Different mechanisms, such as damage to posterior or anterior tracheal wall, false passage or paratracheal placement or dislocation of the cannula are considered to be responsible for the development of pneumothorax and subcutaneous emphysema. Although bronchoscopic control after the tracheostomy procedure did not reveal any tracheal in jury, we believe that subcutaneous emphysema and bilateral pneumothorax are most likely caused by procedure induced injuries of the trachea in addition to the applied high airway pressure induced by excessive or inappropriate ventilation. In our case report, we would like to emphasize that continuous bronchoscopic guidance during percutaneous tracheostomy is invaluable in decreasing the incidence of its overall complications, especially during enhancing the team experience.

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Percutaneous Dilational Tracheostomy

Abstract: Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.

Cited by 161 publications

References 31 publications

Percutaneous tracheostomy by forceps dilation: report of 162 cases

Percutaneous tracheostomy by forceps dilation: report of 162 cases

Complications of midline‐open tracheotomy in adults

Bilateral Pneumothorax as a Complication of Percutaneous Tracheostomy: Case Report

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