Percutaneous tracheostomy: One center's experience with a new modality

Lillian Liao, John Myers, Joe Johnston, Michael Corneille, Daren Danielson, Daniel Dent, Ronald Stewart, Basil Pruitt, H. David Root, Stephen Cohn

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: A retrospective review of our experience with percutaneous tracheostomy was performed to determine our complication rate and pattern of use since this modality was introduced at our institution. Methods: A retrospective chart review captured all patients in whom tracheostomy was performed or supervised by a trauma/critical care faculty member. Dates of hospital admission, ICU admission, intubation, discontinuation of mechanical ventilation, type and location of procedure, procedural complications, Injury Severity Score, charges, and patient demographics were collected. Percutaneous tracheostomy (PT) and open tracheostomy (OT) experiences were compared. Results: Three hundred sixty-eight tracheostomies were performed (190 OT and 178 PT). The average time to tracheostomy (TTT) for PT patients decreased from 12.7 to 7.4 days. The average TTT for OT patients remained stable at 14.0 days. The complication rate was 3.5%, with 4 complications (1.5%) associated with OT and 9 complications (5.1%) associated with PT. All complications in the PT group occurred before using a single dilator system. The 9 complications in the PT group occurred among 5 surgeons, all before their 11th attempt. PT saves $444 in charges per procedure. Conclusion: OT continues to be a safe method of performing tracheostomies. PT has a steep learning curve but can be mastered quickly. Benefits include a shorter time to tracheostomy, elimination of patient transport, and saving in charges. Initial PT attempts should be supervised by an experienced surgeon.

Original languageEnglish (US)
Pages (from-to)939-944
Number of pages6
JournalAmerican Journal of Surgery
Volume190
Issue number6
DOIs
StatePublished - Dec 2005

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Keywords

  • Complications
  • Dilational tracheostomy
  • Percutaneous tracheostomy
  • Surgical tracheostomy
  • Tracheostomy

ASJC Scopus subject areas

  • Surgery

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