Kunz Tina, Strametz Reinhard, Gründling Matthias, Byhahn Christian
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapiedes Klinikums der JohannWolfgang Goethe-Universität, Frankfurt/Main.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Oct;47(10):598-604. doi: 10.1055/s-0032-1325292. Epub 2012 Oct 24.
Percutaneous tracheostomy has become an established procedure in airway management of critically ill patients. It offers advantages over prolonged tracheal intubation. To date, there is no evidence of the optimal timing of the procedure. The Ciaglia Blue Rhino technique is the most common technique and, as any other techniques of percutaneous tracheostomy, is performed under general anaesthesia and with continuous bronchoscopic control. The recently introduced Ciaglia Blue Dolphin technique is based on radial dilatation with a fluid-filled high pressure balloon. Provided that specific contraindications are observed (e.g. difficult tracheal intubation, inability to identify anatomic landmarks, severe coagulopathy etc.), all techniques have low complication rates. The use of ultrasound may further enhance perioperative safety. Finally it must be noted that percutaneous tracheostomy is an elective procedure that requires informed consent from the patient or an attorney of law.
经皮气管切开术已成为危重症患者气道管理中的既定操作。与长时间气管插管相比，它具有优势。迄今为止，尚无证据表明该操作的最佳时机。Ciaglia Blue Rhino技术是最常用的技术，与其他经皮气管切开术技术一样，在全身麻醉和持续支气管镜控制下进行。最近推出的Ciaglia Blue Dolphin技术基于使用充液高压球囊进行径向扩张。只要注意特定的禁忌症（如气管插管困难、无法识别解剖标志、严重凝血功能障碍等），所有技术的并发症发生率都很低。超声的使用可能会进一步提高围手术期安全性。最后必须指出，经皮气管切开术是一项择期手术，需要患者或法定代理人的知情同意。
