Our percutaneous tracheostomy experiences using the rotation-dilatation screw method

Introduction

A tracheostomy procedure is indicated for urgent airway control, to avoid complications of lengthened endotracheal intubation and to make weaning easier. Today, percutaneous tracheostomy techniques are preferred to classical surgical tracheostomy and the use is spreading. Ciaglia's multiple dilatation technique, the Blue Rhino single dilatation technique, the Griggs dilatation forceps technique and the rotation-dilatation screw technique are the most preferred techniques for percutaneous tracheostomy [1, 2]. The aim of this study is to retrospectively assess the techniques used for tracheostomy, tracheostomy time after intensive care admittance, length of intensive care stay and tracheostomy complications in our clinic.

Methods

After approval of the hospital ethics committee, files of the patients on whom the tracheostomy was performed between 2007 and 2009 were evaluated retrospectively. Demographic data of the patients, tracheostomy time after intensive care admittance, length of total intensive care stay and related complications were registered.

Results

Files of 35 patients were evaluated on whom tracheostomy was performed between 2007 and 2009. The male-to-female ratio was 17/18, mean age of the patients was 57.4 ± 20.1 years (16 to 81 years, min to max), mean intensive care stay was 33.4 ± 26.4 days (5 to 103 days, min to max). Mean tracheostomy time after intensive care admittance was 13 ± 8 days (2 to 45 days, min to max). The rotation-dilatation screw technique was used for 34 patients and the Griggs dilatation forceps technique was preferred for one of the patients. No complication was observed for any of the patients.

Conclusions

Studies comparing the ease of performance, early and late complications and long-term results of different percutaneous tracheostomy techniques do not exist. Different advantage/disadvantage ratios are reported in literature related to early and late tracheostomy performance time after admittance. In our clinic practice, the decision for the tracheostomy time is different for each patient. The mean tracheostomy time shows our clinic prefers late tracheostomy. In the aspect of complications, we did not observe complications reported in the literature.