title: Percutaneous dilatational tracheostomy: a self-drive control technique with video fiberoptic bronchoscopy reduces perioperative complications.
abstract: BACKGROUND
  The aim of this study was to demonstrate that performance of percutaneous dilatational tracheostomy (PDT) associated with a self-drive control technique lowers the incidence of complications.
  
  
  METHODS
  A case-control, before-and-after, retrospective study. Place of study: A major teaching hospital in the Department of Emergency, Intensive Care Unit.
  
  
  METHODS
  we studied 128 patients who underwent fiberoptic-guided PDT over an 18 month period of time. Thirty-nine patients were assisted by conventional fiberoptic bronchoscopy, while 89 video-assisted fiberoptic procedures were performed in which the operator controlled his own actions on a screen. We defined perioperative complications as accidental extubation, perioperative hemorrhage, tracheal ring rupture, lesions of the tracheal wall, and abnormal insertion of the cannula. A Chi-square test, Student's t-test and U Mann Whitney test were used to compare the incidence of complications and the duration of procedure in the traditional fiberoptic PDT group and in the video-guided group.
  
  
  RESULTS
  Procedure time was significantly shorter in the group with the self-drive control technique. There was also a reduction of the number of perioperative complications.
  
  
  CONCLUSIONS
  Fiberoptic bronchoscopy associated with a video system seems effective in reducing the risk of perioperative complications.
authors.affiliation: Unit of Anesthesia and Intensive Care, Department of Emergency, Careggi Teaching Hospital, Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Peris
authors.forename: M
authors.initials: M
authors.lastname: Linden
authors.forename: G
authors.initials: G
authors.lastname: Pellegrini
authors.forename: V
authors.initials: V
authors.lastname: Anichini
authors.forename: A
authors.initials: A
authors.lastname: Di Filippo
mesh_terms: D000328:Adult; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D055100:Optical Fibers; D011183:Postoperative Complications / Q000517:prevention & control*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods*