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Reduction of complication rate in percutaneous dilation tracheostomies

, : Reduction of complication rate in percutaneous dilation tracheostomies. Laryngoscope 117(1): 172-175

Percutaneous dilation tracheotomy (PDT) is now an accepted alternative to surgical tracheotomy in certain patients. We began performing these procedures in 2000 and use it regularly in select intensive care unit patients requiring prolonged intubation and mechanical ventilation. A retrospective chart review of consecutive PDTs performed in the Department of Otolaryngology-Head and Neck Surgery at the John Hopkins Hospital between 2002 and 2005 was undertaken. Procedural and postoperative complications in an earlier group were compared with those in the later group for both frequency and severity. Three hundred eighteen PDTs were performed on intensive care patients during this time period. All were performed using the Ciaglia method and the Cook Blue Rhino (Cook Medical Products, Bloomington, IN) set under direct bronchoscopic visualization. In group A (first 159 patients), there were a total of 12 complications (7.5%), including six cases of perioperative hemorrhage, whereas in group B (second 159 PDTs), there were seven complications (4.4%) with no cases of perioperative hemorrhage. PDT provides an easy and convenient alternative to open tracheotomy (OT) and should be added to the otolaryngologist's armamentarium of surgical airway procedures. The complication rate of PDT is low and similar to that of open operative tracheotomy. However, with experience and the use of strict protocols in both patient selection and PDT procedure, the complication rate can be significantly reduced further both in frequency and severity, making it even safer than an open operative tracheotomy.


PMID: 17202948

DOI: 10.1097/01.mlg.0000246197.89602.cb

Other references

Preston, S.B., 1954: The influence of phenolic resin adhesives on the shrinkage properties of veneer laminates. Tests show that the dimensional change in the glue-line plane, caused by a change in moisture content, is restrained by film-type (not by powder type) phenol-formaldehyde glue. For both glue fypes, shrinkage at right angles to the glue line increa...

Ryzhov A.A.; Yakushev V.S., 1990: The enzymic activity in the internal membrane of cardiac mitochondria and spectrum of fatty acids in blood with myocardial necrosis reproduced after the stress. An increase of proton permeability, creation of the possibility for the superoxide radical O2- to escape and a decrease in the oxidation rate of acetyl-CoA due to the stress origin with such membrane-bound enzymes as succinate dehydrogenase and cy...

Johnson, H.S.; Inderbitzen-Nolan, H.M.; Schapman, A.M., 2005: A comparison between socially anxious and depressive symptomatology in youth: a focus on perceived family environment. The current study employed present-oriented self-report measures to compare groups of socially anxious, depressed, mixed socially anxious and depressed, and comparison youth on perceptions of the family environment, as assessed via the Family Envi...

Sagar, V.; Chaturvedi, S.K.; Schuck, P.; Wistow, G., 2017: Crystal Structure of Chicken γS-Crystallin Reveals Lattice Contacts with Implications for Function in the Lens and the Evolution of the βγ-Crystallins. Previous attempts to crystallize mammalian γS-crystallin were unsuccessful. Native L16 chicken γS crystallized avidly while the Q16 mutant did not. The X-ray structure for chicken γS at 2.3 Å resolution shows the canonical structure of the su...

Julius, T.; Kemp, S.E.G.; Kneeshaw, P.J.; Chaturvedi, A.; Drew, P.J.; Turnbull, L.W., 2005: MRI and conservative treatment of locally advanced breast cancer. The objectives of this study were to compare the efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the response of primary breast carcinoma to neoadjuvant chemotherapy compared to conventional imaging modaliti...

Bonifacino, R.; Craig, P.; Carter, S.; Malgor, R.; Dixon, J., 1993: Partial characterization of antigens in circulating immune complexes in cystic hydatid patients treated with albendazole. Immune complexes were precipitated by 3% polyethylene glycol from 4 sera from albendazole-treated hydatid patients from Uruguay, and together with sheep hydatid cyst fluid were analysed by ion-exchange fast protein liquid chromatography (FPLC). FP...

Wilson Michael R.; Fallick Anthony E.; Hamilton P.J.seph; Persson Lars, 1986: Magma sources for some mid-Proterozoic granitoids in SE Sweden; geochemical and isotopic constraints. Geologiska Foereningen i Stockholm Foerhandlingar 108(1): 79-91

Gimeno, M.J.; Honduvilla, N.G.; Guerrero, A.; Lopez Hervas, P.; Bujan, J.; Bellon, J.M., 2000: Metalloproteinase-2 overexpression in the transversalis fascia of patients with direct inguinal hernia. European Surgical Research 32(Suppl 1): 90, June

Campbell, M.S.; Kotlyar, D.S.; Brensinger, C.M.; Lewis, J.D.; Shetty, K.; Bloom, R.D.; Markmann, J.F.; Olthoff, K.M.; Shaked, A.; Reddy, K.Rajender., 2005: Renal function after orthotopic liver transplantation is predicted by duration of pretransplantation creatinine elevation. In patients with recent onset renal insufficiency, the decision to perform combined kidney/liver transplantation (CKLT) vs. orthotopic liver transplantation alone (OLTa) can be difficult. We hypothesized that duration of renal dysfunction may corr...

Imshenetskaya V.F., 1970: Laboratory estimation of antibiotic efficiency in neuro surgery. Antibiotiki (Moscow) 15(11): 1041-1044