Percutaneous dilation tracheotomy in intensive care unit patients

Objectives: In our department, we routinely use percutaneous dilation tracheotomy (PDT) in select intensive care unit (ICU) patients requiring prolonged intubation and mechanical ventilation. We present our experience with this technique and discuss the pros and cons of PDT in the intensive care setting. Study Design and Setting: We conducted a retrospective study of consecutive PDTs performed in our institution between 2002 and 2004. Demographic information and procedural and postoperative complications were noted. Results: Two hundred seventy-four PDTs were performed on intensive care unit patients during this time period. Complications included five cases of excessive intraoperative bleeding (1.8%), one postoperative hemorrhage (0.3%), one tracheoesophageal fistula (0.3%), one pneumothorax (0.3%), and four accidental decannulations (1.4%). No PDT-associated deaths occurred. Conclusions: PDT is advantageous for the patient as it is performed at bedside in the ICU. It is our conclusion that this technique is suitable for many, but not all, critical care patients.