Hill B B, Zweng T N, Maley R H, Charash W E, Toursarkissian B, Kearney P A
Division of General Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084, USA.
J Trauma. 1996 Aug;41(2):238-43; discussion 243-4. doi: 10.1097/00005373-199608000-00007.
To evaluate the procedure time, complications, and percutaneous dilational tracheostomy (PDT) charges.
Operative data were prospectively collected for 356 PDTs including the initial series of 141 PDTs reported in 1994. Short- and long-term complications were retrospectively identified by review of medical records and patient telephone interviews.
PDT was performed using the "Ciaglia" method of serial dilation over a Seldinger guidewire. Discharged patients (n = 258) were followed for a mean (+/-SD) of 10 +/- 7 months.
The mean procedure time was 15 +/- 8 minutes; operative mortality rate, 0.3% (1/356); overall complication rate, 19% (69/356); long-term symptomatic tracheal stenosis rate, 3.7% (8/214). The mean total patient charge for bedside PDT was $1,370; for open tracheostomy in the operating room, $2,675.
Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.
