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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES CRITICAL AND INTESNIVE CARE
Minerva Anestesiologica 2003 November;69(11):825-33
language: English, Italian
Ciaglia percutaneous dilational tracheostomy. Early and late complications and follow-up
Gambale G. 1, Cancellieri F. 1, Baldini U. 2, Vacchi Suzzi M. 3, Baroncini S. 2, Ferrari F. 1, Petrini F. 2
1 ICU-118, Emergency Department Ospedale Maggiore, Bologna, Italy
2 Specialization School of Anesthesia and Resuscitation, Faculty of Medicine University of Bologna, Bologna, Italy
3 Division of Otorhinolaryngology Ospedale Maggiore, Bologna, Italy
Aim. Evaluation of the safety of percutaneous dilational tracheostomy (PDT) for perioperative, early and late complications.
Methods. Design: we prospectively collected complications in patients who underwent PDT for mechanical ventilation; patients were interviewed 8 months after discharge, symptomatic cases underwent ENT control. Setting: 10 bed general ICU in a 650 -bed general hospital treating 450 patients per year. Participants and intervention: 181 patients admitted between July 1998 and June 2000 who underwent PDT for mechanical ventilation. Prospe-ctive collection of data on patients and procedures and screening by a phone interview for symptoms possibly related to the tracheostomy. Symptomatic patients were referred to the ENT specialist.
Resuts. We found 17 perioperative minor complications and 10 minor during hospital stay complications. We traced 83 patients, alive 8 months after discharge. Sixty-one patients (73.5%) were symptom free. Four (4.8) complained of minimal dysphonia. Eighteen patients (21.7%) complained of symptoms deserving ENT control. Eleven patients came to the ENT control that was positive in 5 cases. In 2 patients swallowing uncoordination was found, in 1 arytenoid movement uncoordination. In 1 case (1.2%) a 25% tracheal stenosis was found. The stenosis was asymptomatic. One patient (1.2%) had a severe tracheal stenosis and had a Montgomery tracheal stent in place.
Conclusion. In our experience Ciaglia PDT had an overall low rate of complications (21.8%). No patient had severe early complication. We found only 1 (1.2%) severe late complication. In selected patients, Ciaglia PDT with endoscopic control guarantees a high safety standard.