Percutaneous tracheostomy by forceps dilation: report of 162 cases

Abstract

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.

Complications of midline‐open tracheotomy in adults

“…[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. [9][10][11][12][13][14][15][16][17] Complications not related to tracheotomy are acknowledged to occur in a considerable number of patients in intensive care units after tracheotomy due to severe comorbidities.…”

“…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).…”

Pneumothorax during percutaneous tracheostomy ― a brief review of literature on attributable causes and preventable strategies

“…Tension pneumothorax can result when the intrapleural pressures exceed the atmospheric pressure [21].…”

Otorhinolaryngological problems occurring within the intensive care unit

“…While seemingly easy, complications might and do occur [40,41]. Indeed, their incidence may be higher than with open tracheotomy [42], mainly due to an inability to reinsert a tracheostomy tube following accidental extrusion.…”