Percutaneous tracheostomy (PT) has advantages over traditional tracheostomy as it is easy to do and complications are relatively infrequent. The objective was to find the complications during and immediately after PT.
Retrospective study of patients with PT guided with bronchoscopy from September 1999 to December 2002. Complications during and after the procedure were investigated, as well as the reason for PT and length of stay (LOS). We searched for hypotension, hypoxaemia, bleeding, tracheal laceration or rupture of the tracheal ring, misplacement and subcutaneous emphysema. Of the immediate complications we looked for haemorrhage, infections, pneumothorax, pneumomediastinum, accidental dislodgement, subglothic stenosis, and a valve phenomenon.
We included 30 patients 21 (70%) male and 9 (30%) female with mean age of 49 ± 19 (17-84) years. Causes for PT: 23 (76%) inadequate management of secretions, 6 (20%) long-term mechanical ventilation and 1 (3%) hypoxic encephalopathy. Mean time of mechanical ventilation was 18 ± 11 (3-42) days and mean time for the complete procedure was 16 ± 3 (10-25) minutes. Complications during the procedure: One (3%) patient with presented subcutaneous emphysema and tracheal laceration. Immediate complications: infection of the wound n-1 (3%), accidental dislodgement n-1 (3%) and 2 (6%) had a valve phenomenon. Mean days of mechanical ventilation after PT were 2 ± 2 (1-7) days, LOS 44 ± 52 (12-210) days and no patients died because of the procedure.CONCLUSIONS: Patients did not develop tracheal stenosis, other major complication or died due to the procedure. We conclude it is a safe technique although we have to compare it with traditional surgery.
In Mexico it is rare to perform PT so we need to increase our numbers to demonstrate the efficacy and security of the method in our population.
A. Zamora, None.