Ai Xiaoshun,Gou Dongyuan,Zhang Li,Chen Liying.[J].Chin J Traumatol,2014,17(6):335-337. [doi]

Percutaneous dilatational tracheostomy for ICU patients with severe brain injury

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KeyWord: Brain injuries Percutaneous dilatational tracheostomy ICU

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Author Name	Affiliation
Ai Xiaoshun	Department of Surgery, The 98th Hospital of PLA, Huzhou 313000,Zhejiang Province, China
Gou Dongyuan	Department of ICU, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China
Zhang Li	Department of ICU, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China
Chen Liying	Department of ICU, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China

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Abstract:

Objective: To sum up our experience in percutaneous dilatational tracheostomy (PDT) in ICU patient with severe brain injury. Methods: Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, efficacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results: The operations took 4-15 minutes (mean 9.1 minutes±4.2 minutes). Totally 4 cases suffered from complications in the operations: 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, or clinically significant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion: Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in difficult airway management.

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