Is there a difference in complication rates between surgical tracheostomy and percutaneous dilatational tracheostomy (PDT) in critically ill patients?
BOTTOM LINE
In critically ill patients, percutaneous dilatational tracheostomy (PDT) appears to be a safe and efficient alternative to open surgical tracheostomy.
Explore this issue:
November 2016Background: In the critical care setting, tracheostomy can be performed using either an open or percutaneous technique. Despite many studies comparing the procedures, there remains no consensus on which of these techniques minimizes complications in this patient population.
Study design: Literature search of the following databases: Ovid MEDLINE, Embase, Google Scholar, and Cochrane Database of Systematic Reviews. Studies published between 1985 and 2014, published in French or English in peer-reviewed journals, were included.
Method: Titles and abstracts were independently screened by two reviewers to assess relevance. Data were extracted from studies using a prewritten data entry form.
Synopsis: A total of 550 studies were assessed for relevance, and 22 were deemed eligible for analysis. The total number of patients included was 1,608. With regard to rates of mortality, intraoperative hemorrhage, and postoperative hemorrhage, there was no statistically significant difference between the techniques. Evaluation of infections rates and operative time, however, revealed a statistically significant difference, favoring PDT over surgical tracheostomy.
Citation: Johnson-Obaseki S, Veljkovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients. Laryngoscope. 2016;126: 2459–2467.