Percutaneous dilational tracheostomy: a comparison of single- versus multiple-dilator techniques.
OBJECTIVE
To compare the safety and efficacy of single- vs. multiple-dilator techniques in the performance of percutaneous dilational tracheostomy.


METHODS
Prospective randomized trial.


METHODS
Intensive care units at a level 1 trauma center.


METHODS
Fifty consecutive patients requiring tracheostomy for airway control or prolonged mechanical ventilatory support.


METHODS
Patients were randomized to receive a percutaneous dilational tracheostomy by either the single- or multiple-dilator technique described by Ciaglia.


RESULTS
Percutaneous dilational tracheostomy was performed using the single-dilator technique in 6:01 +/- 3:03 mins and by the multiple-dilator technique in 10:01 +/- 4:26 mins (p <.0006). There were no statistically significant differences in complication rates between the two techniques. No major complications occurred with either technique.


CONCLUSIONS
The single-dilator percutaneous tracheostomy technique is a safe, cost-effective, and more rapidly performed method for bedside tracheostomy in the intensive care unit.
Johnson
J L
JL
Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida, USA.
Cheatham
M L
ML
Sagraves
S G
SG
Block
E F
EF
Nelson
L D
LD
D000328:Adult; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome