Evaluation of a new technique for bedside percutaneous tracheostomy.
BACKGROUND
Percutaneous tracheostomy as described by Ciaglia is accepted as a safe technique with minimal associated morbidity. Recent modification of the technique to a single-step dilator prompted us to evaluate this in the critically injured patient.


METHODS
A comparison of patients undergoing percutaneous tracheostomy was performed. From May 1998 to May 1999, patients underwent surgery using the sequential multidilator technique (MDT), and from July 1999 to July 2000, patients underwent surgery using the single dilation technique (SDT).


RESULTS
Ninety-three tracheostomies were performed, 49 MDT and 44 SDT. Time to tracheostomy and total ventilator days was similar between the groups. Three complications occurred. In the MDT group, 1 patient experienced delayed tracheal hemorrhage not requiring transfusion. In the SDT group, 1 patient had transient right lower lobe collapse, and another patient had unexplained extubation requiring emergent cricothyroidotomy.


CONCLUSIONS
Percutaneous tracheostomy using the single-step Rhino dilator technique is technically easier than the currently accepted multidilator technique with equivalent complications.
Cothren
Clay
C
Department of Surgery, Denver Health Medical Center, 777 Bannock, Denver, CO 80204, USA. clay.cothren@uchsc.edu
Offner
Patrick J
PJ
Moore
Ernest E
EE
Haenel
James B
JB
Biffl
Walter L
WL
de Souza
A L
AL
Johnson
Jeffrey L
JL
D015331:Cohort Studies; D004638:Emergency Treatment / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011336:Probability; D012680:Sensitivity and Specificity; D013997:Time Factors; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome