Increasingly Popular Technique Safe Despite Concerns


Date: 11/27/00

( -- Researchers writing in the World Journal of Surgery argue that, despite the reservations of some health care professionals, percutaneous dilatational tracheostomy (PDT) is a safe method of airway management for critically ill patients.

PDT is easier to perform and more cost-effective than traditional tracheostomies, in part due to the fact that it can be done without moving the patient to an operating room. However, say authors G.C. Velmahos and colleagues at the University of Southern California, "concerns have been raised as to its safety, especially when it is done at the bedside."

Velmahos and colleagues evaluated the results of 100 PDTs, 84 of which were performed at the patient's bedside in the intensive care unit ("Bedside percutaneous tracheostomy: Prospective evaluation of a modification of the current technique in 100 patients," World J Surgery, 2000;24(9):1109-1115).

Only four patients suffered from post-tracheostomy complications, the researchers found. All of the problems - three cases of surgical emphysema resulting from tracheal lacerations and one dislodged cannula - were successfully controlled without the need for surgery.

After a follow-up of six to 18 months, only one long-term adverse effect - persistent hoarseness - was reported by patients, study data showed. No mortality related to the procedure was reported.

Velmahos and colleagues concluded that "bedside PDT is safe and easy to teach when performed with a technique that ensures correct instrumentation."

The corresponding author for this report is G.C. Velmahos, University of Southern California, Dept. of Surgery, 1200 N. State St., Room 9900, Los Angeles, CA 90093 USA.

Key points reported in this study include:

This article was prepared by Health & Medicine Week editors from staff and other reports.

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