TY - JOUR
T1 - Repeat bedside percutaneous dilational tracheostomy is a safe procedure
AU - Meyer, Marianne
AU - Critchlow, Jonathan
AU - Mansharamani, Naresh
AU - Angel, Luis F.
AU - Garland, Robert
AU - Ernst, Armin
PY - 2002/1/1
Y1 - 2002/1/1
N2 - Objective: Previous tracheostomy has been considered a relative contraindication for percutaneous dilational tracheostomy. The objective of this study was to assess the safety of percutaneous dilational tracheostomy in critically ill patients with a history of previous tracheostomy. Design: Retrospective, single-center case series of all consecutive patients requiring repeat tracheostomy for continued mechanical ventilatory support. Setting: Intensive care unit of a tertiary-care referral center. Subjects: Fourteen patients (eight female, six male) with a median age of 70 yrs (range, 33-94). All patients had previously undergone tracheostomy. Intervention: Bedside percutaneous dilational tracheostomy. Measurement and Main Results: Subjects' previous tracheostomies dated back between 10 days and 8 yrs. Present intubation time before percutaneous dilational tracheostomy varied between 4 and 30 days. Bedside percutaneous dilational tracheostomy was performed successfully in all 14 patients by trained pulmonologists and surgeons. Eleven patients received an 8-mm and three received a 7-mm tracheostomy tube. There were no significant periprocedural complications, and no patient required surgical revision. The only postprocedural complication was accidental decannulation in one patient, which was managed with repeat percutaneous dilational tracheostomy. Conclusions: Trained physicians can safely perform bedside percutaneous dilational tracheostomy after previous tracheostomy. Percutaneous dilational tracheostomy offers an alternative to surgical tracheostomy in this particular patient population and should not be considered contraindicated.
AB - Objective: Previous tracheostomy has been considered a relative contraindication for percutaneous dilational tracheostomy. The objective of this study was to assess the safety of percutaneous dilational tracheostomy in critically ill patients with a history of previous tracheostomy. Design: Retrospective, single-center case series of all consecutive patients requiring repeat tracheostomy for continued mechanical ventilatory support. Setting: Intensive care unit of a tertiary-care referral center. Subjects: Fourteen patients (eight female, six male) with a median age of 70 yrs (range, 33-94). All patients had previously undergone tracheostomy. Intervention: Bedside percutaneous dilational tracheostomy. Measurement and Main Results: Subjects' previous tracheostomies dated back between 10 days and 8 yrs. Present intubation time before percutaneous dilational tracheostomy varied between 4 and 30 days. Bedside percutaneous dilational tracheostomy was performed successfully in all 14 patients by trained pulmonologists and surgeons. Eleven patients received an 8-mm and three received a 7-mm tracheostomy tube. There were no significant periprocedural complications, and no patient required surgical revision. The only postprocedural complication was accidental decannulation in one patient, which was managed with repeat percutaneous dilational tracheostomy. Conclusions: Trained physicians can safely perform bedside percutaneous dilational tracheostomy after previous tracheostomy. Percutaneous dilational tracheostomy offers an alternative to surgical tracheostomy in this particular patient population and should not be considered contraindicated.
KW - Repeat percutaneous tracheostomy
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U2 - 10.1097/00003246-200205000-00006
DO - 10.1097/00003246-200205000-00006
M3 - Article
C2 - 12006792
AN - SCOPUS:0036250305
VL - 30
SP - 986
EP - 988
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 5
ER -