Percutaneous Dilatational Tracheotomy in Non‐ICU Wards

Abstract

Objective: To retrospectively assess the feasibility of bedside PDT in nonintensive care wards using a novel joint Otolaryngology-Intensive Care Team model. A control group composed of patients that underwent PDT in the ICU was used to assess the relative complication rate and outcome. Method: A working protocol was constructed defining all stages of the process. All early and late complications were recorded. Other parameters analyzed were patient epidemiology, preprocedure morbidity, staff learning curve, duration of procedure, anesthetics administered, interval from ventilation to weaning, and interval to decannulation. Endpoints were hospital discharge, decannulation, and death. Results: From September 2009 until July 2010 a total of 98 PDTs were performed; 48 PDTs were performed in the hospital wards, and 45 PDTs were performed in the ICU. No life-threatening complications were encountered in the non-ICU group and no significant difference in complication rate was observed between the 2 groups. Conclusion: Percutaneous tracheotomy is an available, safe, low cost procedure which may be safely performed bedside in non-ICU wards by a qualified team. This novel approach may greatly simplify the process of tracheotomy performance, eliminating much of the excess time, hassle, and cost without compromising safety and success rate.