title: Percutaneous dilational tracheostomy: an initial experience in community based teaching hospital.
abstract: Percutaneous dilational tracheostomy (PDT) is frequently performed in the intensive care unit to prevent the long term complications associated with prolonged endotracheal intubation.
  
  
  OBJECTIVE
  To report the analysis of our experience with percutaneous dilation tracheostomy.
  
  
  METHODS
  A prospective documentation of 40 patients who received percutaneous dilational tracheostomy in a multidisciplinary intensive care unit during a 12-month period.
  
  
  METHODS
  The patients demographic, indications of intubation and PDT, time required to perform the procedure, complications and the outcome of these patients in the intensive care unit were noted.
  
  
  RESULTS
  Among 425 patients, 40 underwent percutaneous dilational tracheostomy that included 22 females and 18 males with the median age of 35 years. Prolonged ventilatory support was the most common indication for tracheostomy. The average duration of intubation before PDT was 5 days. Median procedure time was 20 minutes. Complications included minor bleeding in two (5%), subcutaneous emphysema with pneumothorax in two patients (5%), tracheal stenosis in three (7.5%), tracheo-esophageal fistula and glottic granuloma in one patient each (2.5%). Among forty patients, 28 (70%) were discharged to the ward, 8 died in intensive care unit and 4 left hospital against medical advice.
  
  
  CONCLUSIONS
  Percutaneous dilational tracheostomy is a safe, quick and effective way for long term airway management in critically ill patients.
authors.affiliation: Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. gs_malla@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Joshi
authors.forename: B
authors.initials: B
authors.lastname: Agrawal
authors.forename: G P
authors.initials: GP
authors.lastname: Deo
authors.forename: B K
authors.initials: BK
authors.lastname: Bhattarai
authors.forename: T R
authors.initials: TR
authors.lastname: Rahman
authors.forename: B K
authors.initials: BK
authors.lastname: Biswas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods / Q000706:statistics & numerical data; D004106:Dilatation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D018579:Patient Selection; D011030:Pneumothorax / Q000209:etiology; D011446:Prospective Studies; D012121:Respiration, Artificial; D012449:Safety; D013352:Subcutaneous Emphysema / Q000209:etiology; D013997:Time Factors; D014135:Tracheal Stenosis / Q000209:etiology; D014139:Tracheostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome