Comperative clinical trial of translaryngeal tracheostomy and forceps dilatational tracheostomy

Introduction

Percutaneous tracheostomy is a well-established technique in the ICU setting. The methods described by Ciaglia et al. and by Griggs et al. are the most popular and have been advocated by many authors. Translaryngeal tracheostomy (TLT) according to Fantoni and Ripamonti was initially introduced in 1997. The aim of the present study was to assess the difficulties and complications of TLT and forceps dilatational tracheostomy (FDT) in critically ill patients.

Methods

Sixty patients were randomized to undergo TLT or FDT. The techniques as described by Griggs and Fantoni were followed with the use of commercially available kits. Statistical analysis was performed using the Student t test. At the end, tracheal injury was assessed by endoscopy.

Results

There were no significant statistical differences regarding the age, sex, Apache II score or the endotracheal intubation between the two groups. Table 1 summarizes the perioperative complications and duration of TLT and FDT.

Table 1

Conclusion

Based on our data we conclude that TLT represents an equally safe percutaneous technique as FDT and is also an attractive alternative in long-term airway access in critically ill patients.