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Volume 5 Supplement 5

21st International Symposium on Intensive Care and Emergency Medicine

Percutaneous tracheostomy in patients with ARDS on HFOV

Introduction

High Frequency Oscillator Ventilation (HFOV) is a novel lung protective strategy in the treatment of patient with acute respiratory distress syndrome (ARDS). Percutaneous tracheostomy (PCT) has become the preferred mode of achieving long-term airway in ventilated patients, to facilitate weaning and airway toileting.

Aim

To demonstrate the safety and practicability of performing a percutaneous tracheostomy on patients with ARDS whilst on a high frequency oscillator ventilator (HFOV).

Method

Percutaneous tracheostomy was performed using either Ciaglia serial dilatation or Ciaglia 'Blue Rhino' (CBR) techniques, once there was an improvement in gas exchange.

Results

See Table.

Table 1

Discussion

In our group of five patients we performed a percutaneous tracheostomy once we were sure that their lung injury was improving i.e. improved P/F ratio, with a decreasing mean airway pressure to achieve it. There was no worsening of gas exchange perioperatively, nor was there complication associated with the percutaneous tracheostomy.

Conclusion

It is safe to perform a PCT in patient with resolving ARDS on HFOV.

References

  1. 1.

    Colan AA, Kopec SE: Tracheostomy in ICU. A review. J Intensive Care Med 2000, 15: 1-13. 10.1016/0166-218X(86)90013-2

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Shah, S., Read, M. & Morgan, P. Percutaneous tracheostomy in patients with ARDS on HFOV. Crit Care 5, P008 (2001). https://doi.org/10.1186/cc1078

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Keywords

  • Public Health
  • Emergency Medicine
  • Respiratory Distress
  • Lung Injury
  • Respiratory Distress Syndrome