The Comparison of Complications of Tracheostomy in Percutaneous Tracheostomy with Surgical Tracheostomy

Introduction & Percutaneous Dilatational Tratheostomy (PDT) is an elective procedure increasingly performed at bedside in intensive care unit (ICU). With this technique the complications during transferring to the operating room, duration between one patient candidate for PDT to perform it and cost decreased compared to the standard technique. In our study we compared the duration and complications of tracheostomy in percutaneous tracheostomy with surgical tracheostomy. In this clinical trial 18 patients candidating PDT underwent PDT with Griggs method in the ICU (Group 1) and simultaneously compared with 18 patients that underwent surgical tracheostomy (group 2). The two groups based on characteristics such as age, sex, hemodynamic variables (systolic blood pressure, diastolic blood pressure, heart rate), pulmonary function, and oxygenation measured by pulse oximetry were similar. The duration of stay in ICU was also similar between the two groups. Mean delay time among the candidates to perform tracheostomy in group 1 was 1.38±0.6 (1-3) days and in group 2 was 4.55±2.33 (2-10) days respectively, (p<0.001). Mean duration of tracheostomy in the both groups was 11±2.93 (8-30) minutes and 13.77±6.19 (7-30) minutes respectively, (p<0.05). The bleeding occurred in one case (5.6%) in the PDT group and 5 patients (27.8%) in the group 2, (p=0.17).The two groups were similar with respect to infection on site of tracheostomy, trauma to the posterior wall of trachea, subcutaneous emphysema, morbidity and mortality due to tracheostomy, and other complications. PDT technique with regard to delay time to perform tracheostomy, duration of this procedure, and bleeding is preferred to the standard surgical technique.. Moreover, PDT is safer and more cost-effective than the standard technique. Other complications and mortality were similar in the two groups.