Comparison of Percutaneous Dilatational Tracheostomy with Open Tracheostomy in Intensive Care Unit
2019
Introduction
Tracheostomy is one of the frequent surgical procedure carried out in intensive care unit. Percutaneous
tracheostomy is becoming increasingly popular compared to conventional open surgical tracheostomy in ICU.
Methods
A prospective randomized trial with twenty patients in each group was conducted to compare the outcomes of
percutaneous and surgical tracheostomy. Percutaneous tracheostomy was performed using Ciaglia Blue Rhino
technique and surgical tracheostomy was performed using established technique. The outcomes were compared
in relation to randomization to tracheostomy, completion of procedure, intra operative and post-operative
complications, hospital length of stay and cost.
Results
There were no major complications in either group. Most variables studied were not statistically significant.
The two groups did not differ in terms of basic demographics or APACHE II score. The only variables to reach
statistical significance were time duration from tracheostomy randomization to start of procedure and time taken
for completion of procedure. It was mean 31.85±15.35 hours in Percutaneous Tracheostomy group and in Surgical
Tracheostomy group it was mean 49.10±23.61 hours respectively (p<0.009). Time taken to perform percutaneous
tracheostomy was mean 15.50±3.22 minutes and for surgical tracheostomy it was mean 20.30±3.38 minutes.
(p<0.001).
Conclusion
Percutaneous dilatational tracheostomy is simple, faster to perform and can be done at bedside to avoid
considerable delay in the performance of open tracheostomy where there is high demand for elective and
emergency procedures in operating room.
Keywords:
Complications, intensive care unit, percutaneous tracheostomy, surgical tracheostomy
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