Introduction & Objective: 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.Materials & Methods: In this clinical trial 18 patients candidating PDT underwent PDT with Griggs method in the ICU (Group I) and simultaneously compared with 18 patients that underwent surgical Tracheostomy (group 2).Results: 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 I 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.Conclusion: 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.

Background: Prolonged intubation and need to mechanical ventilation is an indication for Tracheostomy. This procedure can be done, surgical or percutaneous. In this study, we compare surgical and percutaneous dilated Tracheostomy.Methods: In this retrospective study, which was conducted in ICU wards of Rasool Akram Hospital from Mehr 1387 to Mehr 1390. We compared complication of tracheostomized patients in two groups.Results: In this study, early postoperative bleeding, in 11 cases, 1case (4.2%) in PDT group and 10 cases (17.5%) in surgical group was shown (with a significant difference). Surgical site infection in 1 case, 2 cases (7.4%) in PDT group and 1 case (4.2%) in surgical group was shown (with a non-significant difference). Subcutaneous emphysema in 11 cases, 2 case (8.3%) in PDT group and 1 case (1.7%) in surgical group with a significant difference, was shown. Other complications such as tracheal posterior wall were not shown in both groups.Conclusion: Because of lower complications rate and bedside PDT doing, percutaneous Tracheostomy is a safe and suitable alternative for surgical Tracheostomy.

Background: Percutaneous dilatational Tracheostomy (PDT) is a common surgical procedure in the ICU. The present study was conducted to compare semi-surgical percutaneous dilatational Tracheostomy (SSPDT) with conventional percutaneous dilatational Tracheostomy (CPDT). Methods: The present randomized clinical trial was conducted on 160 patients hospitalized in the medical intensive care units (ICUs) with an indication for Tracheostomy and were systematically divided into two equal groups of 80. In the CPDT group, after a small incision, a 16-gauge needle was blindly inserted into the trachea and the guidewire was placed inside the lumen. A stoma was created by passing a single dilator over the guidewire. In the SSPDT group, a transverse incision (2 cm) was made 1 cm below the cricoid, and the tracheal ring was then fully reached by releasing the subcutaneous tissues using the index figure, and PDT was then performed. The two groups were compared in terms of their Tracheostomy complications (including bleeding, pneumothorax, stoma infection and accidental decannulation) and duration of the procedure. Results: The two groups were homogeneous in terms of age, gender, mean APACHE score (P>0. 05). There were no significant differences between the two groups in terms of the mean time from tracheal intubation to Tracheostomy (P=0. 869). The duration of the procedure was 5. 16± 1. 72 minutes in the SSPDT group and 6. 42± 1. 71 in the CPDT group (P<0. 001). The complication rate was 7(8. 75%) in the SSPDT group and 16(20%) in the CPDT group (P=0. 043). Conclusion: SSPDT is safer and has fewer complications than CPDT in ICU patients.

In order to achieve a long-term airway, one of two ways is used: Endotracheal intubation and Tracheostomy. Tracheostomy is sometimes hazardous with serious complications and outcomes, especially in pediatric groups, while endotracheal intubation is accompanied with lighter complications. The author, based on a 32-year experience from 1978 to 2010, having performed 83 tracheostomies with various indications in both pediatric and elderly groups and having compared the two groups, believes Tracheostomy is a safe alternative way to establish airway in I.C.U. centers.