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Erschienen in:
01.04.1999 | Review
Percutaneous tracheostomy
Erschienen in: Critical Care | Ausgabe 2/1999
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Background
Percutaneous tracheostomy (PT) has gained an increasing acceptanceas an alternative to the conventional surgical tracheostomy (ST). Inexperienced hands, and with proper patient selection, it is safe, easy andquick.
Complications
Perioperative complications are comparable with those of ST andthese are mostly minor. An important advantage of PT over ST is that there isno need to move a critically ill patient to the operating room and the rate ofstomal infection is very low. Although data on late complications of PT are notyet sufficient, available reports show a favourable result.
Techniques
Ciaglia's method is the most commonly applied, but no studyhas shown superiority of any of the percutaneous techniques described. Thedecision on which method to use should solely be made depending on the clinicalsituation and the experience of the operator. The learning curve demandscaution, attention to detail and adequate experience on the part of theintensive care physician. Although PT is unfortunately declared'easy', it must be left in the hands of experienced physicians toavoid unnecessary complications, and the risk of overimplementation should bekept in mind.