PERCUTANEOUS DILATATIONAL CRICOTHYROIDOTOMY - OUTCOME WITH 44 CONSECUTIVE PATIENTS

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.