Ciaglia percutaneous dilational tracheostomy. Early and late complications and follow-up.
OBJECTIVE
Evaluation of the safety of percutaneous dilational tracheostomy (PDT) for perioperative, early and late complications.


METHODS



METHODS
we prospectively collected complications in patients who underwent PDT for mechanical ventilation; patients were interviewed 8 months after discharge, symptomatic cases underwent ENT control.


METHODS
10 bed general ICU in a 650 -bed general hospital treating 450 patients per year.


METHODS
181 patients admitted between July 1998 and June 2000 who underwent PDT for mechanical ventilation. Prospe-ctive collection of data on patients and procedures and screening by a phone interview for symptoms possibly related to the tracheostomy. Symptomatic patients were referred to the ENT specialist. RESULTA: We found 17 perioperative minor complications and 10 minor during hospital stay complications. We traced 83 patients, alive 8 months after discharge. Sixty-one patients (73.5%) were symptom free. Four (4.8) complained of minimal dysphonia. Eighteen patients (21.7%) complained of symptoms deserving ENT control. Eleven patients came to the ENT control that was positive in 5 cases. In 2 patients swallowing uncoordination was found, in 1 arytenoid movement uncoordination. In 1 case (1.2%) a 25% tracheal stenosis was found. The stenosis was asymptomatic. One patient (1.2%) had a severe tracheal stenosis and had a Montgomery tracheal stent in place.


CONCLUSIONS
In our experience Ciaglia PDT had an overall low rate of complications (21.8%). No patient had severe early complication. We found only 1 (1.2%) severe late complication. In selected patients, Ciaglia PDT with endoscopic control guarantees a high safety standard.
Gambale
G
G
CU-118, Emergency Department, Ospedale Maggiore, Bologna, Italy. ggambal@tin.it
Cancellieri
F
F
Baldini
U
U
Vacchi Suzzi
M
M
Baroncini
S
S
Ferrari
F
F
Petrini
F
F
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods*