Prospective study of percutaneous tracheostomy: Role of bronchoscopy and surgical technique:

摘要

Objective:Percutaneous tracheostomy is a common procedure but varies considerably in approach. The aim of our study was to evaluate the need for intraoperative bronchoscopy and to compare various surgical techniques.Methods:During 1?year all percutaneous tracheostomies in three intensive care units were prospectively documented according to a unified protocol. In one unit, bronchoscopy was used routinely and in others only during the study.Results:A total of 111 subjects (77 males) with median age 64 (range, 18–86) years and body mass index 25.4 (range, 15.9–50.7) were included. In unit A, tracheal wall was directly exposed; in unit B, limited dissection to enable tracheal palpation was made. In both units, bronchoscopy was used to check the location of an already inserted guiding needle; needle position required correction in 8% and 12% of cases, respectively. In unit C, in tracheostomies without pretracheal tissue dissection, bronchoscopy was used to guide needle insertion; needle position required corr...