Percutaneous dilational tracheostomy: report of 356 cases.
OBJECTIVE
To evaluate the procedure time, complications, and percutaneous dilational tracheostomy (PDT) charges.


METHODS
Operative data were prospectively collected for 356 PDTs including the initial series of 141 PDTs reported in 1994. Short- and long-term complications were retrospectively identified by review of medical records and patient telephone interviews.


METHODS
PDT was performed using the "Ciaglia" method of serial dilation over a Seldinger guidewire. Discharged patients (n = 258) were followed for a mean (+/-SD) of 10 +/- 7 months.


RESULTS
The mean procedure time was 15 +/- 8 minutes; operative mortality rate, 0.3% (1/356); overall complication rate, 19% (69/356); long-term symptomatic tracheal stenosis rate, 3.7% (8/214). The mean total patient charge for bedside PDT was $1,370; for open tracheostomy in the operating room, $2,675.


CONCLUSIONS
Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.
Hill
B B
BB
Division of General Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084, USA.
Zweng
T N
TN
Maley
R H
RH
Charash
W E
WE
Toursarkissian
B
B
Kearney
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014139:Tracheostomy / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome