Percutaneous dilatational tracheostomy versus open tracheostomy--a prospective, randomized, controlled trial.
BACKGROUND
Percutaneous dilatational tracheostomy has gained popularity, but its superiority to open tracheostomy is unclear. The object of this study was to compare procedure time, complication, safety and cost-effect between the percutaneous dilatational tracheostomy (PDT) and the conventional open tracheotomy (OT).


METHODS
A prospective randomized clinic trial was conducted in a general Intensive Care Unit of an University-based hospital. Eighty-three consecutive patients who needed elective tracheostomies were selected for this study. PDT was performed using the Ciaglia method with OT as control group. Age, gender, operative data, complications and mortality were recorded for analysis.


RESULTS
The procedure time was 22.0 +/- 12.1 minutes in PDT group, and 41.5 +/- 5.9 minutes in OT group, with significant statistical difference (p < 0.001). The incidences of complications were not different between both groups. Ages, gender or days of pre-tracheostomy intubation showed no difference between two groups.


CONCLUSIONS
The PDT appears to be a simple, safe and time-saving bedside procedure. It can be recommended when an elective tracheostomy is needed in a critical patient.
Wu
Jackson Jer-Kan
JJ
Division of Trauma, Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. jkwu@vghtpe.gov.tw
Huang
Mu-Shun
MS
Tang
Gau-Jun
GJ
Shih
Shin-Chin
SC
Yang
Chih-Chieh
CC
Kao
Wei-Fong
WF
Huang
Min-Hsiung
MH
Lee
Chen-Hsen
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014139:Tracheostomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*