Year : 2007  |  Volume : 1  |  Issue : 1  |  Page : 9

Clinical experience with 100 cases of percutaneous dilatational tracheostomy with and without bronchoscopic guidance

1 Senior Registrar of Anesthesia, Saudi Arabia
2 Assistant Professor of Anesthesia, Saudi Arabia
3 Professor of Anesthesia, Saudi Arabia
4 Associate Professor of Anesthesia, Saudi Arabia
5 Assistant Professor of Thoracic Surgery, Saudi Arabia

Correspondence Address:
S Nawaz
Department of Anaesthesia, King Khalid University Hospital, Post Box 7805, Riyadh, 11472
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

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We performed 100 cases of percutaneous tracheostomy with forceps dilatational method in a period of 20 months. 50 cases were performed under bronchoscopic guidance (group A) and other 50 cases without bronchoscopic guidance (group B). 54 patients underwent procedure in Surgical Intensive Care Unit (SICU), 36 patients in operating room and 10 in the other areas of the hospital. Maximum number of patients (37) was neurosurgical. Only 2 patients underwent tracheostomy in first 5 days, whereas 76 of them had tracheostomy done between 11-20 days of endotracheal ventilation. Technical difficulties were encountered during the procedure in both groups. We found that tracheal puncture (25 cases) and forceps dilatation (13 cases) are difficult steps of the procedure requiring multiple attempts and supervision. We did not encounter any life threatening and major complications. However commonest complication during the procedure was minor bleeding (9%). Other complications in both groups were in the similar range and negligible. Absence of bronchoscopic guidance has not increased the morbidity directly but the procedural time was increased significantly in group A (8.76 min) compared to group B (6.04 min) in group B.

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