F. Barrachina et al., PERCUTANEOUS DILATATIONAL CRICOTHYROIDOTOMY - OUTCOME WITH 44 CONSECUTIVE PATIENTS, Intensive care medicine, 22(9), 1996, pp. 937-940
Objective: To assess the value of the percutaneous dilatational techni
que in elective cricothyroidotomy. Design: Forty-four consecutive pati
ents requiring prolonged mechanical ventilation. Setting: The general
14-bed intensive care unit of a university hospital. Interventions: Fo
urty-four percutaneous dilatational cricothyroidotomies using a multip
le-dilator wire-guided procedure. Measurements and results: The averag
e duration for the procedure was 11 min in 37 patients. No significant
complications occurred intraoperatively except for one paratracheal c
annula insertion. Postoperative complications were one case of stoma i
nfection, three cases of transient phonatory changes, two cases of a s
mall peristomal granuloma, and one case of persistent stoma. Of 21 dec
annulated patients, 16 survived to discharge. Long-term follow-up was
possible in 14 surviving patients. All were asymptomatic several month
s after decannulation. Conclusions: Percutaneous dilatational cricothy
roidotomy can be a quick, safe technique, as good as the percutaneous
subcricoidal approach in ventilated, critically ill patients.