TITLE

Percutaneous Dilational Tracheostomy in a Community Intensive Care Unit

AUTHOR(S)
Henderson, William
PUB. DATE
June 2008
SOURCE
European Journal of Trauma & Emergency Surgery;Jun2008, Vol. 34 Issue 3, p294
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Percutaneous dilational tracheostomy (PDT) is increasingly being used to replace traditional surgical tracheostomy (ST) in the management of critically ill patients. There is considerable controversy regarding the safety of this procedure in the hands of non-surgeons, and most data so far have come from large tertiary care centres. We report our experience and safety data in the implementation of a PDT program for critically ill patients in a teaching community hospital in an attempt to demonstrate that this procedure can be performed safely outside of an academic ICU. Prospective observational study in a large community teaching hospital. All patients without contraindications were considered for enrollment. Contraindications to PDT included evidence of infection at the surgical site, the presence of a coagulopathy not correctable to an international normalized ratio of less than 1.5, or unstable cervical spine injuries. A total of 42 patients were included in the study and all received PDT using the Ciaglia Blue Rhino single dilator introducer set (Cook Critical Care, Bloomington, IN, USA). Data collected included patient age, sex, reason for intubation, and complications. Of 42 patients, 25 were males, and 17 were females. The average age was 47.6 years (range 16–87 years). The commonest admitting diagnosis was traumatic brain injury, followed by sepsis and cardiac arrest. Our total recorded complication rate was 7.1%, with no deaths. There were two episodes of transient hypotension (4.8%). Percutaneous dilational tracheostomy appears to be at least as safe as traditional ST, and may have advantages with respect to timeliness and minimization of patient transport. The complication rate seen in our program is similar to that seen in other PDT series.
ACCESSION #
32627179

 

Related Articles

  • Assessment of Early Tracheostomy in Trauma Patients: A Systematic Review and Meta-Analysis. Dunham, C. Michael; Ransom, Kenneth J. // American Surgeon;Mar2006, Vol. 72 Issue 3, p276 

    The objective of this review was to assess outcomes in trauma patients undergoing early tracheostomy (ET). Abstract databases for the Eastern and American Associations for the Surgery of Trauma and Medline were searched to find trauma patient studies comparing ET and late tracheostomy (LT) or ET...

  • Intubating laryngeal mask as a ventilatory device during percutaneous dilatational tracheostomy: a descriptive study. U. Linstedt; F. Möller; N. Grote; M. Zenz; A. Prengel // BJA: The British Journal of Anaesthesia;Dec2007, Vol. 99 Issue 6, p912 

    Background We use an intubating laryngeal mask (ILM) in preference to an endotracheal tube (ETT) as the ventilatory device during percutaneous dilatational tracheostomy (PDT) to overcome potential problems such as difficult ventilation, accidental extubation, damage of the ETT or of the...

  • Comparing percutaneous tracheostomy with open surgical tracheostomy. Susanto, Irawan // BMJ: British Medical Journal (International Edition);1/5/2002, Vol. 324 Issue 7328, p3 

    Editorial. Compares percutaneous tracheostomy with open surgical tracheostomy. Popularity of percutaneous dilational tracheostomy which is done at the bedside in the intensive care unit; Costs of percutaneous tracheostomy and bedside open surgical tracheostomy; Safety of percutaneous and...

  • Tracheostomy management. Regan, Kate; Hunt, Katharine // Continuing Education in Anaesthesia, Critical Care & Pain;Feb2008, Vol. 8 Issue 1, p31 

    The article describes the different types of tracheostomy tube and how to manage emergencies. Types of tracheostomy tubes include single and double cannula tubes and fenestrated and unfenestrated tubes. When managing a blocked tracheostomy, the anaesthetist is often called. Factors that should...

  • Percutaneous tracheostomy in critically ill patients: 24 months experience at a tertiary care hospital in United Arab Emirates. Ahmed, Raees; Rady, Sherif R.; Siddique, Javed Iqbal Mohammad; Iqbal, Mobeen // Annals of Thoracic Medicine;Jan-Mar2010, Vol. 5 Issue 1, p26 

    OBJECTIVE: We assessed the safety and complications related to percutaneous tracheostomy (PCT) without bronchoscopic guidance in our intensive care unit (ICU). METHODS: The prospective data over a period of 24 months were collected for patients who underwent PCT. Major, minor and long-term...

  • tracheotomy. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p754 

    A definition of the term "tracheotomy," which refers to the cutting of the trachea, is presented.

  • Decannulation and Outcome Following Pediatric Tracheostomy. Leung, Randal; Berkowitz, Robert G. // Annals of Otology, Rhinology & Laryngology;Oct2005, Vol. 114 Issue 10, p743 

    Objectives: We investigated the long-term outcome of pediatric tracheostomy to identify predictive factors of early decannulation. Methods: We performed a retrospective chart review of a consecutive series of 75 patients less than 20 years of age who underwent tracheostomy between 1998 and 2003...

  • Managing Adults With Tracheostomies and Ventilator-Dependence. Dikeman, Karen J.; Kazandjian, Marta S. // ASHA Leader;10/19/2004, Vol. 9 Issue 19, p6 

    Focuses on the development of care for adults with trracheostomies. More literature and presentations on the topic of tracheostomy and ventilator dependence; Competencies of the clinician handling the patients; Effect of tracheostomy tube on voice restoration. INSETS: Tracheostomy Tubes:...

  • Acquired Subglottic Cysts in Preterm Infants. Johnson, Liane B.; Rutter, Michael J.; Shott, Sally R.; Cotton, Robin T. // Journal of Otolaryngology;Mar/Apr2005, Vol. 34 Issue 2, p75 

    Objectives: Acquired subglottic cysts (SGCs) are a recognized complication of intubation in preterin inlants. A brief window of our experience is reviewed to determine the demographics and outcomes of therapy. Design: A retrospective review encompassing patients diagnosed and treated front 2001...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics