title: [Bronchoscopy-guided percutaneous tracheostomy. A safe technique in intensive care].
abstract: BACKGROUND
  When compared with conventional surgery, bronchoscopy-guided percutaneous tracheostomy has demonstrated some advantages. We compare the results obtained with bronchoscopy-guided percutaneous tracheostomy performed by Intensive Care Unit personnel with those of conventional surgery.
  
  
  METHODS
  Prospective and descriptive cohort of patients admitted to a respiratory intensive care unit from March 2010 to March 2012.
  
  
  RESULTS
  A total of 510 patients were admitted to the respiratory Intensive Care Unit. Tracheostomy was performed in 51 (10%); of which, 27 (53%) underwent bronchoscopy-guided percutaneous tracheostomy, and 24(47%) underwent tracheostomy by conventional surgery. There were no differences between bronchoscopy-guided percutaneous tracheostomy and conventional surgery groups in age (52 ± 16 vs 53 ± 18 years, p = 0.83). Simplified Acute Physiology Score-3 differed among groups (59.4 ± 11.2 vs 51.5 ± 14.3, p = 0.03). Indications for performing tracheostomy were prolonged intubation (74.1% vs 62.5%, p = 0.55), neurologic impairment (22.2% vs 16.6%, p = 0.88), and laryngeal disease (3.7% vs 20.8%, p 0.14). Mean time between intubation and tracheostomy was 13.3 days (range 4-45) vs 13.4 days (range 2-40). There were three minor complications in bronchoscopy-guided percutaneous tracheostomy patients, transient bigeminism in one, and moderate bleeding in two, and one minor complication of moderate bleeding in one patient in the conventional surgery group, p = 0.68.
  
  
  CONCLUSIONS
  Bronchoscopy-guided percutaneous tracheostomy is a versatile and safe alternative for conventional tracheostomy when performed in Intensive Care Unit by personnel with expertise and appropriate training.
authors.affiliation: Unidad de Cuidados Intensivos Respiratorios, Servicio de Neumología y Cirugía de Tórax, Hospital General de México O.D. "Dr. Eduardo Lizeaga," Balmis, D.F., México. pamyacs@yahoo.com
authors.forename: Pablo
authors.initials: P
authors.lastname: Álvarez-Maldonado
authors.forename: Abel
authors.initials: A
authors.lastname: Pérez-Rosales
authors.forename: Carlos
authors.initials: C
authors.lastname: Núñez-Pérez Redondo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Cueto-Robledo
authors.forename: Francisco
authors.initials: F
authors.lastname: Navarro-Reynoso
authors.forename: Raúl
authors.initials: R
authors.lastname: Cicero-Sabido
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000379:methods* / Q000706:statistics & numerical data; D003422:Critical Care / Q000379:methods*; D003953:Diagnosis-Related Groups; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007442:Intubation, Intratracheal; D007818:Laryngeal Diseases; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases; D010564:Personnel, Hospital; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D012124:Respiratory Care Units; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D020535:Video-Assisted Surgery
keywords: Intensive Care Units; bronchoscopy; percutaneous tracheostomy