Repeat bedside percutaneous dilational tracheostomy is a safe procedure

Marianne Meyer, Jonathan Critchlow, Naresh Mansharamani, Luis F. Angel, Robert Garland, Armin Ernst

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)986-988
Number of pages3
JournalCritical care medicine
Volume30
Issue number5
DOIs
StatePublished - Jan 1 2002

Keywords

  • Repeat percutaneous tracheostomy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Meyer, M., Critchlow, J., Mansharamani, N., Angel, L. F., Garland, R., & Ernst, A. (2002). Repeat bedside percutaneous dilational tracheostomy is a safe procedure. Critical care medicine, 30(5), 986-988. https://doi.org/10.1097/00003246-200205000-00006