Comparison of Percutaneous and Surgical Tracheostomies

Friedman, Yaakov; Fildes, John; Mizock, Barry A.; Jacob, Samuel; Patel, Samir R.; Appavu, Samuel K.; Roberts, Richard M.

doi:10.1378/chest.110.2.480

Cited by 305 publications

(205 citation statements)

References 33 publications

Supporting

Mentioning

176

Contrasting

Unclassified

Order By: Relevance

“…Freeman et al [12] analysed five prospective studies with 236 patients and observed that the operative bleeding rate ranged between 0% and 20% and the postoperative bleeding between 0% and 12%. We consider the definition of the amount of bleeding proposed by Friedman et al [13] as small (25-100 ml), moderate (100-250 ml) and severe (> 250 ml) is the most appropriate.…”

Section: Discussionmentioning

confidence: 99%

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

et al. 2008

View full text Add to dashboard Cite

Summary Percutaneous tracheostomy is used primarily to assist weaning from mechanical ventilation in the intensive care unit. We report our experiences of 800 such procedures performed in the intensive care unit by a collaborative team (critical care and ENT specialists). Most procedures (85.6%) were performed by residents supervised by the intensive care unit staff. Complications occurred in 32 patients (4%). Intraprocedural complications occurred in 17 patients (2.1%), early postprocedural complications in six (0.75%), and late postprocedural complications in nine (1.1%). No deaths were directly related to percutaneous tracheostomy. The incidence of complications was greater in percutaneous tracheostomy performed by the residents during their initial five attempts compared to their later attempts (9.2% vs 2.6%, p < 0.05). The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure in daily care of intensive care unit patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

et al. 2008

View full text Add to dashboard Cite

show abstract

“…7,8 Advantages and complications of both methods have been compared with conflicting results in literature. [9][10][11][12][13][14][15][16][17] Unfortunately, many studies failed to include the whole spectrum of complications, and in all studies patients were selected, with high-risk patients excluded from PT. That makes it difficult to come to representative conclusions.…”

Section: Introductionmentioning

confidence: 99%

Complications of midline‐open tracheotomy in adults

et al. 2009

View full text Add to dashboard Cite

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.

show abstract

“…Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure that is becoming the method of choice for securing airway in critically ill patients who need prolonged ventilation support 1,2 . PDT is one of the most frequently performed procedures in intensive care units (ICU) and has become established as the alternative method over conventional surgical tracheostomy (ST) for long-term intubated patients.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Pneumothorax as a Complication of Percutaneous Tracheostomy: Case Report

Klancir¹,

Adam

Mršić³

et al. 2016

ACC

View full text Add to dashboard Cite

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.

show abstract

Comparison of Percutaneous and Surgical Tracheostomies

Cited by 305 publications

References 33 publications

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

Complications of midline‐open tracheotomy in adults

Bilateral Pneumothorax as a Complication of Percutaneous Tracheostomy: Case Report

Contact Info

Product

Resources

About