Complications of dilatative percutaneous tracheostomy in German otorhinolaryngological departments.

Aim: This study was carried out to clarify complications which need interve ntion from otorhinolaryngologists after percutaneous dilatational tracheost omy (PDT). Method: In October 1996 questionnaires were sent to all heads of otorhinolaryngological departments in Germany. The first part of this ques tionnaire dealt with the frequency and application of PDT. In the second qu estionnaire specifications were made about complications that had been obse rved personally by the head of the department. The questionnaire enquired n ot only about complications in his or her own patients, but in all patients that had been referred to the department. Results: Of the departments cont acted 78% returned evaluated questionnaires. The most frequently used metho d was the modification described by Ciaglia. This method was more often use d by anesthesists and specialists in internal medicine and general surgery. PDT was in use in 10% of the ENT departments. The most frequently observed complications were bleeding during the change of the canula and tracheal s tenosis. Four fatal cases were reported in connection with PDT. Almost half of the department heads responding felt PDT was not appropriate for intens ive care patients. Thirty-three percent believed that PDT was suitable, Thr ee percent thought that PDT was a more effective method than conventional t racheostomy.