TRANSLARYNGEAL TRACHEOSTOMY - TECHNIQUE A ND EARLY EXPERIENCE

Translaryngeal tracheostomy is a new type of minimally invasive techni que for bedside tracheostomy in intensive care patients. After percuta neous puncture of the trachea below the first tracheal ring, a conic t racheal cannula is fixed to an orally forwarded guide wire. The cannul a is then pulled through in orthograde fashion set up, rotated and pus hed forward caudally Among the first 25 translaryngeal tracheostomies in 24 patients, only two complications appeared: one misplacement of t he cannula and one infection of the stoma. During a median apnoea time of about 80 s an average PaCO2 increase of 8.0 +/- 6.8 mmHg was docum ented; hypoxias could not be seen. Translaryngeal tracheostomy seems t o be an appropriate alternative to established tracheostomy methods.