Журнал интенсивной и интенсивной терапии Открытый доступ

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Percutaneous Dilational Tracheostomy With or Without Bronchoscopic Guidance: A Retrospective Analysis of 201 Patients in an Intensive Care Unit of a Tertiary Care Centre

Agrawal VK, Bansal A, Jain A, Singh RK, Kumawat BL, Sharma N

Introduction: Tracheostomy is one of many common procedures in intensive care unit which can be performed in two ways: open or surgical tracheostomy (ST) and Percutaneous Dilational Tracheostomy (PDT). PDT is preferred and performed with or without bronchoscopic guidance. We retrospectively analysed all cases of tracheostomy performed in our Intensive care unit.

Materials & Methods: We did a retrospective study and analysis of 209 patients admitted in our ICU during last two and half years on which tracheostomy were performed, out of which 201 cases were performed PDT. We used both Ciaglia blue rhino and Griggs technique to perform PDT.

Results: A total number of 53 complications were encountered in 14 (7%) patients and with remaining 187 (93%), the patients, procedure was uneventful. Common early complication encountered were minor bleeding (6.5%), transient hypotension (6%) guide wire kinking (5%). Major bleeding (2%), accidental extubation (1%) and false passage (0.5%) were few rare early complications. Infections (4%) and bleeding (1.5%) were delayed complications encountered.

Conclusion: Our study recoiled that tracheostomy with percutaneous dilational technique without bronchoscopic guidance can be performed rapidly, with ease while adhering to safety. It’s without significant procedural complications, if conducted by an ICU physician or intensivist or a person who is well familiar and experienced with the procedure, eventually reducing the cost and duration, which is highly valued in present era.