Published in:
Open Access 01-04-2000 | Research
Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques
Published in: Critical Care | Issue 2/2000
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Background
Although the standard tracheostomy described in 1909 by Jacksonhas been extensively used in critical patients, a more simple procedure thatcan be performed at the bedside is needed. Since 1957 several different typesof percutaneous tracheostomy technique have been described. The purpose of thepresent study was to compare two bedside percutaneous tracheostomy techniques:percutaneous dilatational tracheostomy (PDT) and the guidewire dilating forceps(GWDF).
Materials and methods
A prospective study in two medical/surgical intensive care units(ICUs) was carried out. Sixty-three critically ill patients who requiredendotracheal intubation for longer than 15 days were consecutively selected toundergo PDT (25 patients) or GWDF (38 patients) technique. Intraoperative andpostoperative complications were recorded.
Results
Age (mean ± standard error) was 63 ± 1.1 years. Thepatients had been mechanically ventilated for an average of 19.8 ± 1.2days. The GWDF technique was significantly faster than PDT technique(P = 0.02). Fifteen complications occurred in 10 out of 63 (15%)patients. They were as follows: tracheal tear (one patient in each group; inone case this was due to false passage); transient hypotension (one patient inthe PDT group and two patients in the GWDF group); atelectasis (one patient inthe PDT group); and haemorrhage (one patient in the PDT group and threepatients in the GWDF group). In both patients with tracheal tear, reducedarterial oxygen saturation (SaO2) with concomitant subcutaneousemphysema ensued.
Conclusion
We found no statistical differences between complications withboth techniques. The surgical time required for the GWDF technique was lessthan that for PDT.