Comparison of percutaneous and surgical tracheostomies.
OBJECTIVE
To compare the safety and efficacy of percutaneous dilational tracheostomy (PDT) with surgical tracheostomy (ST).


METHODS
Prospective randomized trial.


METHODS
Public urban teaching hospital.


METHODS
Twenty-six patients were randomized to undergo PDT and 27 patients to ST.


RESULTS
The time from randomization into the study until tracheostomy was performed was 28.5 +/- 27.9 h in the PDT group and 100.4 +/- 95.0 h in the ST group (p < 0.001). PDT was performed in 8.2 +/- 4.9 min vs 33.9 +/- 14.0 min for ST (p < 0.0001). There was no significant difference in intraprocedural complications between the groups. Postprocedural complication rates were 12% for PDT and 41% for ST (p = 0.008).


CONCLUSIONS
PDT is superior to ST logistically. PDT can be performed at the bedside eliminating the risk of patient transport. Because operating room scheduling is not necessary, PDT can be performed earlier once the decision to do a tracheostomy is made, which will improve ICU utilization. PDT is a faster procedure to perform and has fewer postprocedural complications.
Friedman
Y
Y
Department of Medicine, Cook County Hospital, Chicago, IL 60615, USA.
Fildes
J
J
Mizock
B
B
Samuel
J
J
Patel
S
S
Appavu
S
S
Roberts
R
R
D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods*