title: Pitfalls in percutaneous dilational tracheostomy using the Ciaglia one-step technique.
abstract: Surgical tracheostomy was first described in 1909. Since then, it has become a standard procedure for patients requiring prolonged mechanical ventilation. More recently, bedside percutaneous tracheostomy has been shown to be as safe and effective as the surgical technique, but with the added advantage of also being technically straightforward and cost-efficient. Partly because of this, percutaneous tracheostomy is now being performed by nonsurgeon intensivists. However, the relative ease of the procedure may mask many potential pitfalls that can result in morbidity. As such, it is important for all intensivists to be familiar with the steps and potential pitfalls of this procedure. This is an evidence-based review of the common pitfalls associated with the Ciaglia one-step percutaneous tracheostomy technique, the method most commonly utilized for percutaneous tracheostomy insertion in the United States.
authors: Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. saranib@uphs.upenn.edu
authors: Babak
authors: B
authors: Sarani
authors: William
authors: W
authors: Kinkle
authors: Patrick
authors: P
authors: Reilly
mesh_terms: D004106:Dilatation / Q000009:adverse effects / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D007431:Intraoperative Complications; D012121:Respiration, Artificial / Q000379:methods; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods*