Percutaneous dilation tracheotomy in intensive care unit patients.
OBJECTIVE
In our department, we routinely use percutaneous dilation tracheotomy (PDT) in select intensive care unit (ICU) patients requiring prolonged intubation and mechanical ventilation. We present our experience with this technique and discuss the pros and cons of PDT in the intensive care setting.


METHODS
We conducted a retrospective study of consecutive PDTs performed in our institution between 2002 and 2004. Demographic information and procedural and postoperative complications were noted.


RESULTS
Two hundred seventy-four PDTs were performed on intensive care unit patients during this time period. Complications included five cases of excessive intraoperative bleeding (1.8%), one postoperative hemorrhage (0.3%), one tracheoesophageal fistula (0.3%), one pneumothorax (0.3%), and four accidental decannulations (1.4%). No PDT-associated deaths occurred.


CONCLUSIONS
PDT is advantageous for the patient as it is performed at bedside in the ICU. It is our conclusion that this technique is suitable for many, but not all, critical care patients.
Bhatti
Nasir
N
Department of Ototolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Tatlipinar
Arzu
A
Mirski
Marek
M
Koch
Wayne M
WM
Goldenberg
David
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004106:Dilatation / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000601:surgery*; D014140:Tracheotomy / Q000379:methods*