Percutaneous dilational tracheostomy or conventional surgical tracheostomy?

Abstract

We found that PDT is a cost-effective procedure in critically ill ICU patients. Although we performed ST at the bedside in the ICU to avoid the risks associated with moving critically ill patients to the operating room, we found PDT to be a simple and safe procedure.

Complications of midline‐open tracheotomy in adults

“…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.…”

“…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. 27 Therefore, we distinguished between complications related to tracheotomy and those occurring independently from this procedure (Table I).…”

“…[9][10][11][12][13][14][15][16][17][18] Complication rates of OT were predominantly evaluated in small patient populations including 50, 26, and 29 patients, respectively. 11,13,14 In contrast to studies evaluating PT, high-risk patients were included in studies evaluating OT. 9,11,16 Complication rates of OT range between 3.8% (n ¼ 26) and 97% (n ¼ 27).…”

“…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).…”

“…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.…”