title: Percutaneous dilatational tracheostomy with bronchoscopic guidance: Ramathibodi experience.
abstract: BACKGROUND
  Tracheostomy is considered as the airway management of choice for patients in the ICU who require prolonged mechanical ventilation or airway protection. Percutaneous dilational tracheostomy (PDT) was first described in 1985 and now is a well-established procedure that can be performed at the bedside by a pulmonologist with less surgical equipment required.
  
  
  METHODS
  A retrospective analysis.
  
  
  METHODS
  Twelve patients underwent PDT because of prolonged endotracheal intubation between March and December 2006. The procedures were done by using bedside percutaneous dilatation tracheostomy with guidewire dilator forceps (GWDF) technique with bronchoscopic guidance under general anesthesia in either the intensive care unit or the intermediate care unit of Department of Medicine, Ramathibodi Hospital.
  
  
  RESULTS
  There were seven men and five women with a mean age of 55.0 +/- 11.8 years. Operative mortality was 0%. Procedure related complication was not found Operation time in each case was less than ten minutes. Bronchoscopic examination performed in one of the cases after one month of tracheostomy tube removed showed no scar at the tracheostomy site.
  
  
  CONCLUSIONS
  PDT with bronchoscopic guidance is a safe and easy procedure that can be done by pulmonologist at the bedside setting.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. bss-vb@hotmail.com
authors.forename: Viboon
authors.initials: V
authors.lastname: Boonsarngsuk
authors.forename: Sumalee
authors.initials: S
authors.lastname: Kiatboonsri
authors.forename: Sabaitip
authors.initials: S
authors.lastname: Choothakan
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D004106:Dilatation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D014139:Tracheostomy / Q000379:methods*