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Review
, 41 (2), 238-43; discussion 243-4

Percutaneous Dilational Tracheostomy: Report of 356 Cases

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Review

Percutaneous Dilational Tracheostomy: Report of 356 Cases

B B Hill et al. J Trauma.

Abstract

Objective: To evaluate the procedure time, complications, and percutaneous dilational tracheostomy (PDT) charges.

Design: 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.

Materials and methods: 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.

Measurements and main results: 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.

Conclusions: 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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