Percutaneous Dilational Tracheostomy

Authors:
  • TZThomas N. Zweng
    Thomas N. Zweng
  • RMRichard H. Maley
    Richard H. Maley
  • WCWilliam E. Charash
    William E. Charash
  • BTBoulos Toursarkissian
    Boulos Toursarkissian
  • PKPaul A. Kearney
    Paul A. Kearney
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Abstract
To evaluate the procedure time, complications, and percutaneous dilational tracheostomy (PDT) charges. Operative data were prospectively collected for 356 PDTs including the initial series of 141 PDTs reported in 1994. Short- and long-term complications were retrospectively identified by review of medical records and patient telephone interviews. PDT was performed using the "Ciaglia" method of serial dilation over a Seldinger guidewire. Discharged patients (n = 258) were followed for a mean (+/- SD) of 10 +/- 7 months. The mean procedure time was 15 +/- 8 minutes; operative mortality rate, 0.3% (1/356); overall complication rate, 19% (69/356); long-term symptomatic tracheal stenosis rate, 3.7% (8/214). The mean total patient charge for bedside PDT was $1,370; for open tracheostomy in the operating room, $2,675. Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.

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