PERCUTANEOUS DILATATIONAL TRACHEOSTOMY, A NEW METHOD IN INTENSIVE-CARE - PROCEDURE, ADVANTAGES AND RISKS

Background and objective: Percutaneous dilatational tracheostomy (PDT) is a recently developed method to obtain endotracheal access, also at the bed-side, in ventilated patients. The procedure is described and results are presented. Patients and methods: PDT was performed in 112 patients (82 men, 30 women, average age 50.7 years) between 1.5. 1994 and 31.5. 1996, in all cases expected to require more than 10 days of assisted ventilation. All complications, late sequelae and cosmetic re sults after decannulation were analysed. Results: No serious complicat ions were noted during the procedure. Erroneous puncture occurred in n ine patients, but were corrected without problem. Complications necess itating temporary interruption of the tracheostomy consisted of accide ntal extubation and ventilatory problems (two patients each). There we re no late sequelae and the cosmetic results were judged to be very go od. Conclusion: PDT is a simple and relatively easily learned procedur e. It has a low complication rate, late sequelae are very rare and cos metic results after closure of the tracheostomy are excellent.