Percutaneous dilatational tracheostomy: mostly safe, but do benefits outweigh risks?

Damon C Scales,Brian H Cuthbertson

doi:10.1186/cc13761

Abstract

Percutaneous dilatational tracheostomies have become one of the most frequently performed surgical procedures in the ICU, and are believed to offer a variety of advantages over open tracheostomies, including increased convenience. Recent publications have established that the risk of fatal complications related to the procedure is low. However, clinicians must still weigh these risks against expected but largely unproven benefits. More research is needed to establish the indications for the procedure, including the optimal patient selection and timing during a course of mechanical ventilation. Such studies should also seek to improve our ability to accurately identify which patients will require prolonged mechanical ventilation, and to quantify the potential benefits of tracheostomy compared with prolonged translaryngeal intubation.

Highlights

Percutaneous dilatational tracheostomies have become one of the most frequently performed surgical procedures in the ICU, and are believed to offer a variety of advantages over open tracheostomies, including increased convenience
In a previous issue of Critical Care, Simon and colleagues provide a contribution that helps clarify the safety of the percutaneous dilatational tracheostomy procedure [1]
Tracheostomy is one of the most common surgical procedures performed in the ICU [2], and percutaneous tracheostomies have largely replaced the open tracheostomy technique [3,4]

Summary

Introduction

Percutaneous dilatational tracheostomies have become one of the most frequently performed surgical procedures in the ICU, and are believed to offer a variety of advantages over open tracheostomies, including increased convenience. In a previous issue of Critical Care, Simon and colleagues provide a contribution that helps clarify the safety of the percutaneous dilatational tracheostomy procedure [1]. Tracheostomy is one of the most common surgical procedures performed in the ICU [2], and percutaneous tracheostomies have largely replaced the open tracheostomy technique [3,4].

Results

Conclusion