Percutaneous Dilatational Tracheostomy
Percutaneous Dilatational Tracheostomy
Background. Over the past 15 years, many large university hospitals have reported their experience with percutaneous dilatational tracheostomy (PDT). The purposes of this study are to evaluate the safety of PDT in a non-university hospital setting and to compare our results with those published in the literature.
Methods. The study was done by retrospective chart review.
Results. Over a 6-year period, 300 PDTs were done in two community hospitals in Tyler, Texas. There was one death and 12 complications. Comparison of our results and those reported in five recently published articles in the literature showed no significant difference in mortality rate, pneumothorax, bleeding, paratracheal placement, dislodgement, or cellulitis. There was a trend toward a significantly lower incidence of paratracheal placement using bronchoscopic guidance.
Conclusion. Bedside PDT with bronchoscopic guidance can be safely done in a community hospital setting.
Tracheostomy has been done in chronically ventilated patients for more than 30 years. The procedure has multiple benefits. The patient's airway is easier to access, and the patient is more comfortable. The most convincing argument is the stability of the airway once a tracheostomy has been placed and has matured. In the mid-1980s, Ciaglia et al published their experience with PDT and clearly showed that this new method was safe. In August 1992, we began using PDT at East Texas Medical Center and Trinity Mother Frances hospitals in Tyler, Texas. The following is a report of the first 300 PDT procedures.
Background. Over the past 15 years, many large university hospitals have reported their experience with percutaneous dilatational tracheostomy (PDT). The purposes of this study are to evaluate the safety of PDT in a non-university hospital setting and to compare our results with those published in the literature.
Methods. The study was done by retrospective chart review.
Results. Over a 6-year period, 300 PDTs were done in two community hospitals in Tyler, Texas. There was one death and 12 complications. Comparison of our results and those reported in five recently published articles in the literature showed no significant difference in mortality rate, pneumothorax, bleeding, paratracheal placement, dislodgement, or cellulitis. There was a trend toward a significantly lower incidence of paratracheal placement using bronchoscopic guidance.
Conclusion. Bedside PDT with bronchoscopic guidance can be safely done in a community hospital setting.
Tracheostomy has been done in chronically ventilated patients for more than 30 years. The procedure has multiple benefits. The patient's airway is easier to access, and the patient is more comfortable. The most convincing argument is the stability of the airway once a tracheostomy has been placed and has matured. In the mid-1980s, Ciaglia et al published their experience with PDT and clearly showed that this new method was safe. In August 1992, we began using PDT at East Texas Medical Center and Trinity Mother Frances hospitals in Tyler, Texas. The following is a report of the first 300 PDT procedures.
Source...