Percutaneous translaryngeal versus surgical tracheostomy: A randomized trial with 1-yr double-blind follow-up*

Antonelli, Massimo; Michetti, Vincenzo; Palma, Alessandra Di; Conti, Giorgio; Pennisi, Maddalena; Arcangeli, A; Montini, Luca; Bocci, Maria Grazia; Bello, Giuseppe; Almadori, Giovanni; Paludetti, Gaetano; Proietti, R.

doi:10.1097/01.ccm.0000163401.77581.86

Cited by 106 publications

(105 citation statements)

References 27 publications

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“…We also saw a lower incidence of pneumonia in patients undergoing percutaneous tracheostomy (59 vs. 75%, P = 0.011, OR: 0.49 (CI 95%: 0.27-0.89)), whereas others authors have found no difference in the incidence. 79,80 We did not find any difference in terms of mortality and perioperative complications. According to our When a tracheostomy is performed after anterolateral cervical spine fixation, the two incisions come in very close contact, which poses the potential risk of cross-contamination and, therefore, of much feared infection of the osteosynthetic material.…”

Section: Discussionmentioning

confidence: 72%

Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation

Ganuza

Forcada

Gambarrutta

et al. 2011

The Journal of Spinal Cord Medicine

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Objective: To assess the effect of timing and techniques of tracheostomy on morbidity, mortality, and the burden of resources in patients with acute traumatic spinal cord injuries (SCIs) undergoing mechanical ventilation. Design: Review of a prospectively collected database. Setting: Intensive and intermediate care units of a monographic hospital for the treatment of SCI. Participants: Consecutive patients admitted to the intensive care unit (ICU) during their first inpatient rehabilitation for cervical and thoracic traumatic SCI. A total of 323 patients were included: 297 required mechanical ventilation and 215 underwent tracheostomy. Outcome measures: Demographic data, data relevant to the patients' neurological injuries (level and grade of spinal cord damage), tracheostomy technique and timing, duration of mechanical ventilation, length of stay at ICU, incidence of pneumonia, incidence of perioperative and early postoperative complications, and mortality. Results: Early tracheostomy (<7 days after orotracheal intubation) tracheostomy was performed in 101 patients (47%) and late (≥7 days) in 114 (53%). Surgical tracheostomy was employed in 119 cases (55%) and percutaneous tracheostomy in 96 (45%). There were 61 complications in 53 patients related to all tracheostomy procedures. Two were qualified as serious (tracheoesophageal fistula and mediastinal abscess). Other complications were mild. Bleeding was moderate in one case (late, percutaneous tracheostomy). Postoperative infection rate was low. Mortality of all causes was also low. Conclusion: Early tracheostomy may have favorable effects in patients with acute traumatic SC. Both techniques, percutaneous and surgical tracheostomy, can be performed safely in the ICU.

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Section: Discussionmentioning

confidence: 72%

Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation

Ganuza

Forcada

Gambarrutta

et al. 2011

The Journal of Spinal Cord Medicine

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“…La incertidumbre sobre la seguridad de la TPC en relación a la TQx se ha ido despejando en los últimos años [36][37][38] . Silvester y cols 39 , randomizaron 200 pacientes a TPC con la técnica de Ciaglia o TQx.…”

Section: Discussionunclassified

Traqueostomía percutánea con asistencia fibrobroncoscópica: Evaluación prospectiva de 100 casos consecutivos y revisión de la literatura

et al. 2008

Rev. méd. Chile

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“…PCT is easy and safe, and can be performed at the bedside in the ICU, avoiding the risks associated with transport of critically ill patients to the operating room [20,21]. Moreover, it is a simple procedure to learn and, in our experience, a minimum of five to ten procedures under the supervision of an expert physician are advisable to achieve adequate training.…”

Section: No Patientsmentioning

confidence: 99%

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

et al. 2008

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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.

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Percutaneous translaryngeal versus surgical tracheostomy: A randomized trial with 1-yr double-blind follow-up*

Abstract: Compared with ST, the main advantages of TLT are that it is more rapid and associated with less postoperative bleeding. Infectious complications, particularly postoperative bacteremia, and long-term effects (physical and emotional) are similar with the two procedures.

Cited by 106 publications

References 27 publications

Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation

Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation

Traqueostomía percutánea con asistencia fibrobroncoscópica: Evaluación prospectiva de 100 casos consecutivos y revisión de la literatura

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

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