Percutaneous dilatational tracheostomy without fiber optic bronchoscopy—Evaluation of 80 intensive care units cases

  • José Andres Calvache a. Department of Anesthesiology, School of Health Sciences, Universidad del Cauca, Popayan, Colombia. b. Anesthesiology Department, Erasmus University Medical Center, Rotterdam, The Netherlands. c. Biostatistics Department, Erasmus University Medical Center, Rotterdam, The Netherlands
  • Rodrigo A. Molina Garcia Intensive Care Unit, La Estancia Clinic, Popayán, Colombia
  • Adolfo L. Trochez a. Department of Anesthesiology, School of Health Sciences, Universidad del Cauca, Popayán, Colombia. b. Intensive Care Unit, La Estancia Clinic, Popayán, Colombia
  • Federico Benitez a. Department of General Surgery, School of Health Sciences, Universidad del Cauca, Popayán, Colombia. b. Intensive Care Unit, La Estancia Clinic, Popayán, Colombia
  • Lucia Arroyo Intensive Care Unit, La Estancia Clinic, Popayán, Colombia
Keywords: Tracheostomy, Critical care, Bronchoscopy, Artificial respiration

Abstract

Background: The development of percutaneous dilatational tracheostomy techniques (PDT) has facilitated the procedure in Intensive Care Units (ICU).

Objective: To describe the early intra and post-operative complications in ICU patients requiring percutaneous dilatational tracheostomy using the Ciaglia Blue Rhino technique, without fiber optic bronchoscopy.

Patients and methods: We collected data from eighty ICU patients during three years. The demographic variables were recorded, in addition to severity, number of days in mechanical ventilation prior to the procedure and intraoperative as well as early postoperative complications.

Results: Eighty patients were included, with the mean age of 61.5 (15-89) years old (29 females). The mean APACHE II score was 17.9. In average, the patients required 11.6 days of mechanical ventilation prior to the PDT. 11.6% had intraoperative complications and 9.1% experienced early postoperative complications. In two patients the endotracheal tube was accidentally punctured and three patients had self-limiting bleeding at the tracheostomy site. None of the complications was life threatening to the patients.

Conclusions: PDT using the Ciaglia Blue Rhino technique, without fiber optic bronchoscope is a procedure with low incidence of complications.

References

1. Toursarkissian B, Zweng TN, Kearney PA, Pofahl WE, Johnson SB, Barker DE. Percutaneous dilational tracheostomy: report of 141 cases. Ann Thorac Surg. 1994;57:862-7.
2. Byhahn C, Wilke HJ, Halbig S, Lischke V, Westphal K. Percutaneous tracheostomy: Ciaglia blue rhino versus the basic Ciaglia technique of percutaneous dilational tracheostomy. Anesth Analg. 2000;91:882-6.
3. Ciaglia P, Graniero KD. Percutaneous dilatational tracheostomy. Results and long-term follow-up. Chest. 1992;101:464-7.
4. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report, 1985. Chest. 2009;136 Suppl. 5:e30.
5. Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet. 1990;170:543-5. [ Links ]
6. Nates JL, Cooper DJ, Myles PS, Scheinkestel CD, Tuxen DV. Percutaneous tracheostomy in critically ill patients: a prospective, randomized comparison of two techniques. Crit Care Med. 2000;28:3734-9.
7. Quintel M, Roth H. Tracheostomy for the critically ill: impact of new technologies. Current Opinion in Critical Care. 2000;6:46-51.
8. Fajardo R, Pulido H, Henao F. Traqueostomía percutánea. Revista Colombiana de Cirugía. 1999;14:76-80.
9. Whited RE. A prospective study of laryngotracheal sequelae in long-term intubation. Laryngoscope. 1984;94:367-77.
10. Shelden C, Pudenz R, Tichy F. Percutaneous tracheotomy. J Am Med Assoc. 1957;165:2068-70.
11. Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ. 2005;330:1243.
12. Ramírez J, Padilla J, Sánchez M. Traqueostomía percutánea por dilatación: Reporte de 70 casos. Acta Médica Costarricense. 2006;48:77-83.
13. Calvache JA. Traqueostomía percutánea en cuidado Intensivo Internet. Unidad de Cuidados Intensivos Clínica La Estancia S.A.: 2010. Disponible en: http://www.youtube.com/watch?v=3mPt2RqultE
14. Barber V, Bouse C. Tracman. Tracheostomy management in critical care Internet, consultado 1/3/2011. Disponible en: http://www.tracman.org.uk/
15. Fikkers BG, Fransen GAJ, van der Hoeven JG, Briedé IS, van den Hoogen FJA. Tracheostomy for long-term ventilated patients: a postal survey of ICU practice in The Netherlands. Intensive Care Med. 2003;29:1390-3.
16. Krishnan K, Elliot SC, Mallick A. The current practice of tracheostomy in the United Kingdom: a postal survey. Anaesthesia. 2005;60:360.
17. Kluge S, Baumann HJ, Maier C, Klose H, Meyer A, Nierhaus A, et al. Tracheostomy in the Intensive Care Unit: A Nationwide Survey. Anesthesia & Analgesia. 2008;107:1639-3.
18. Reilly PM, Anderson HL, Sing RF, Schwab CW, Bartlett RH. Occult hypercarbia. An unrecognized phenomenon during percutaneous endoscopic tracheostomy. Chest. 1995;107:1760-3.
19. Nawaz S, Delvi M, Channa A, Turkistani A, Hajjar W. Clinical experience with 100 cases of percutaneous dilatational tracheostomy with and without bronchoscopic guidance. Saudi Journal of Anaesthesia. 2007;1:9.
20. Barba CA, Angood PB, Kauder DR, Latenser B, Martin K, McGonigal MD, et al. Bronchoscopic guidance makes percutaneous tracheostomy a safe, cost-effective, and easy-to-teach procedure. Surgery. 1995;118:879-83.
21. Mulder DS, Marelli D, Paul A, Manolidis S, Walsh G, Odim JN, et al. Endoscopic guided percutaneous tracheostomy: early results of a consecutive trial. J Trauma. 1990;30:433-5.
22. Romero PR, Cornejo R, Tobar A, Llanos V, Galvez R, Espinosa MA, et al. Traqueostomía en el paciente crítico. Revista Hospital Clínico Universidad de Chile. 2009;20:148-59.
23. Romero PC, Cornejo RR, Ruiz CM, Gálvez AR, Llanos VO, Tobar AE, et al. Traqueostomía percutánea con asistencia fibrobroncoscópica: Evaluación prospectiva de 100 casos consecutivos y revisión de la literatura. Revista Médica de Chile. 2008;136:1113-20.
24. Jackson LS, Davis JW, Kaups KL, Sue LP, Wolfe MM, Bilello JF, et al. Percutaneous tracheostomy: to bronch or not to bronch - that is the question. J Trauma. 2011;71:1553-6.
25. Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest. 1989;96:178-80.
26. Figueroa J, Delgado T, Osorio MC. Realización de traqueostomía temprana ante la posibilidad de desarrollarse una estenosis subglótica. Acta de Otorrinolaringología & Cirugía de Cabeza y Cuello. 2001;29:10-5.
27. Cheng E, Fee WE. Dilatational versus standard tracheostomy: a meta-analysis. Ann Otol Rhinol Laryngol. 2000;109: 803-7.
28. Massick DD, Yao S, Powell DM, Griesen D, Hobgood T, Allen JN, et al. Bedside tracheostomy in the intensive care unit: a prospective randomized trial comparing open surgical tracheostomy with endoscopically guided percutaneous dilational tracheotomy. Laryngoscope. 2001;111:494-500.
29. Al-Ansari MA, Hijazi MH. Clinical review: percutaneous dilatational tracheostomy. Crit Care. 2006;10:202.
30. Freeman BD, Isabella K, Lin N, Buchman TG. A meta-analysis of prospective trials comparing percutaneous and surgical tracheostomy in critically ill patients. Chest. 2000;118:1412-8.
31. William M, Pasquale C, Kenneth G. Some Important details in the technique of percutaneous dilatational tracheostomy via the modified Seldinger technique. Chest. 1996;110:762-6.
32. Hill BB, Zweng TN, Maley RH, Charash WE, Toursarkissian B, Kearney PA. Percutaneous dilational tracheostomy: report of 356 cases. J Trauma. 1996;41:238-43, discussion 243-244.
33. Moe KS, Stoeckli SJ, Schmid S, Weymuller EA. Percutaneous tracheostomy: a comprehensive evaluation. Ann Otol Rhinol Laryngol. 1999;108:384-91.
34. Holdgaard HO, Pedersen J, Jensen RH, Outzen KE, Midtgaard T, Johansen LV, et al. Percutaneous dilatational tracheostomy versus conventional surgical tracheostomy. Acta Anaesthesiologica Scandinavica. 1998;42:545-50.
35. Durbin CG. Tracheostomy: Why, When, and How? Respir Care. 2010;55:1056-68.
36. Dempsey GA, Grant CA, Jones TM. Percutaneous tracheostomy:a6yrprospective evaluation of the single tapered dilator technique. Br J Anaesth. 2010;105:782-8.
37. Cabrini L, Monti G, Landoni G, Biondi-Zoccai G, Boroli F, Mamo D, et al. Percutaneous tracheostomy, a systematic review. Acta Anaesthesiol Scand. 2012;56:270-81.
How to Cite
1.
Calvache JA, Molina Garcia RA, Trochez AL, Benitez F, Arroyo L. Percutaneous dilatational tracheostomy without fiber optic bronchoscopy—Evaluation of 80 intensive care units cases. Colomb. J. Anesthesiol. [Internet]. 2013Jul.1 [cited 2021Apr.23];41(3):184–189. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/690

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Published
2013-07-01
How to Cite
1.
Calvache JA, Molina Garcia RA, Trochez AL, Benitez F, Arroyo L. Percutaneous dilatational tracheostomy without fiber optic bronchoscopy—Evaluation of 80 intensive care units cases. Colomb. J. Anesthesiol. [Internet]. 2013Jul.1 [cited 2021Apr.23];41(3):184–189. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/690
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