Aclinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients.

Abstract

This study aimed to introduce anovel tracheostomy method, the non-guide-wire percutaneous dilatational tracheostomy (NGPDT) technique, and evaluate its effectiveness for critically ill patients undergoing neurosurgery under special conditions. The clinical data of 48critically ill patients who underwent NGPDT under special conditions with controlled steps were analyzed retrospectively. The patients' demographic, preoperative state of illness, and diagnosis data were collected. Moreover, their intraoperative and postoperative variables were accessed, e.g., operation times, bleeding, saturation of pulse oxygen (SPO2), and early and late complications related to NGPDT. The mean patient age was 47.7 ± 13.7years. The mean GCS (Glasgow Coma Scale) was 8.1 ± 2.9, and the mean BMI (Body Mass Index) was 25.2 ± 5.6. There were 38patients with an endotracheal tube. The mean duration of onset to NGPDT was 4.0 ± 1.3days. The mean operation time was 4.2 ± 1.9 min. There were 41patients with mild intraoperative bleeding, 5with moderate bleeding, and 2with severe bleeding as well as 46with mild postoperative bleeding and 2with moderate bleeding. Additionally, 41patients required complete extubation after NGPDT. The mean duration of incision healing was 4.8 ± 3.1days. There was 1 patient with adecrease of SPO2 ≥ 10%. Three patients presented with atransient violent cough at the primary tracheostomy stage; however, no patients suffered from pneumothorax, subcutaneous emphysema, false passage, or surgery-related death during this procedure. Overall, NGPDT with controlled steps is afast, safe, and microinvasive procedure. It mildly stimulates the trachea with alow rate of complications.