title: Percutaneous dilatational tracheostomy for ICU patients with severe brain injury.
abstract: OBJECTIVE
  To sum up our experience in percutaneous dilatational tracheostomy (PDT) in ICU patient with severe brain injury.
  
  
  METHODS
  Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, efficacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively.
  
  
  RESULTS
  The operations took 4-15 minutes (mean 9.1 minutes ± 4.2 minutes). Totally 4 cases suffered from complications in the operations: 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, or clinically significant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT.
  
  
  CONCLUSIONS
  Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in difficult airway management.
authors.affiliation: Department of Surgery, The 98th Hospital of PLA, Huzhou 313000,Zhejiang Province, China.
authors.forename: Xiao-Shun
authors.initials: XS
authors.lastname: Ai
authors.forename: Dong-Yuan
authors.initials: DY
authors.lastname: Gou
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Chen
mesh_terms: D001930:Brain Injuries / Q000628:therapy*; D003422:Critical Care; D006801:Humans; D061646:Operative Time; D011183:Postoperative Complications; D014139:Tracheostomy / Q000379:methods*; D016896:Treatment Outcome