Percutaneous dilational tracheostomy: Report of 356 cases

Objective: To evaluate the procedure time, complications, and percutaneous dilational tracheostomy (PDT) charges. Design: Operative data were prospectively collected for 356 PDTs including the initial series of 141 PDTs reported in 1994. Short- and long-term complications were retrospectively identified by review of medical records and patient telephone interviews, Materials and Methods: PDT was performed using the ''Ciaglia'' method of serial dilation over a Seldinger guidewire. Discharged patients (n = 258) were followed for a mean (+/- SD) of 10 +/- 7 months. Measurements and Main Results: The mean procedure time was 15 +/- 8 minutes; operative mortality rate, 0.3% (1/356); overall complication rate, 191 (69/356); long-term symptomatic tracheal stenosis rate, 3.78 (8/214), The mean total patient charge for bedside PDT was $1,370; for open tracheostomy in the operating room, $2,675, Conclusions: Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.