The guide wire dilating forceps technique of percutaneous tracheostomy

BACKGROUND: Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. METHODS: In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. RESULTS: Most percutaneous tracheostomies were performed without any advers e effect. No life-threatening complications or deaths were related to the p rocedure. The procedure was successful in 49 of 50 patients (98%). In 1 pat ient the procedure was converted to an open tracheostomy because significan t bleeding occurred. Five perioperative complications, including this signi ficant bleeding and four minor complications, occurred in 50 patients (10%) . Early complications occurred in 6 of 48 patients (13%), including one sig nificant bleeding and five minor complications. A subglottic stenosis occur red in 2 of 36 successfully decannulated patients (6%). In one case this wa s certainly due to prolonged endotracheal intubation, CONCLUSIONS: The GWDF technique is a safe and efficient bedside alternative to open tracheostomy, Fiberscopic control is recommended to increase the s afety of the procedure. Although studies of late complications are necessar y, it appears to be justifiable to consider percutaneous tracheostomy for p atients who require tracheostomy. Am J Surg. 1999;177:311-315. (C) 1999 by Excerpta Medica, Inc.