Percutaneous dilatational cricothyroidotomy: outcome with 44 consecutive patients.

OBJECTIVE

To assess the value of the percutaneous dilatational technique in elective cricothyroidotomy.

DESIGN

Forty-four consecutive patients requiring prolonged mechanical ventilation.

SETTING

The general 14-bed intensive care unit of a university hospital.

INTERVENTIONS

Fourty-four percutaneous dilatational cricothyroidotomies using a multiple-dilator wire-guided procedure.

MEASUREMENTS AND RESULTS

The average duration for the procedure was 11 min in 37 patients. No significant complications occurred intraoperatively except for one paratracheal cannula insertion. Postoperative complications were one case of stoma infection, three cases of transient phonatory changes, two cases of a small peristomal granuloma, and one case of persistent stoma. Of 21 decannulated patients, 16 survived to discharge. Long-term follow-up was possible in 14 surviving patients. All were asymptomatic several months after decannulation.

CONCLUSIONS

Percutaneous dilatational cricothyroidotomy can be a quick, safe technique, as good as the percutaneous subcricoidal approach in ventilated, critically ill patients.