title: Percutaneous dilational tracheostomy: a comparison of single- versus multiple-dilator techniques.
abstract: 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.
authors.affiliation: Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Johnson
authors.forename: M L
authors.initials: ML
authors.lastname: Cheatham
authors.forename: S G
authors.initials: SG
authors.lastname: Sagraves
authors.forename: E F
authors.initials: EF
authors.lastname: Block
authors.forename: L D
authors.initials: LD
authors.lastname: Nelson
mesh_terms: 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