Percutaneous Tracheostomy

DISCUSSION
The technique of tracheostomy in general presents a large number of advantages compared to conventional prolonged endotracheal intubation; improvement of patient’s comfort and the avoidance of laryngeal, cricoidal and high-tracheal injury[15], decreased duration of sedation, earlier weaning from mechanical ventilation and shorter overall length of stay in ICU
[16 ,17,18]. That is why doing early tracheostomy will have positive impact on patient prognosis. The excellent results of percutaneous tracheostomy may influence the decision to perform a tracheostomy rather early. Additionally, the suggestion of a reduction in the duration of translaryngeal intubation prior to the procedure when comparing percutaneous tracheostomy with surgical …show more content…
Crofts et al. [12] in 1995 found that there was no difference in the incidence of complications between the surgical and percutaneous tracheostomy. Meta-analysis done in 2006 comparing Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients revealed that use of percutaneous tracheostomy is associated with a reduced incidence of wound infection compared to surgical tracheostomy in critically ill patients. percutaneous tracheostomy may yield an overall decreased risk of death when compared with surgical tracheostomy. While percutaneous tracheostomy appears equivalent to ST for the overall incidence of clinically relevant bleeding, major peri-procedural and long term complications [13]. Another meta-analysis was published in 2007 has shown that percutaneous tracheotomies trend toward fewer overall complications than open techniques and appear to be more cost-effective by releasing operating room resources including time and personnel and provide greater feasibility in terms of bedside capability[14].

In 1992, it was recommended that percutaneous tracheostomy to be done only by doctors in the surgical field [21] , but one of the major advantages of this technique is that nonsurgically trained members of the health care team may perform the tracheotomy using a Seldinger technique, and this person may be more familiar with the percutaneous technique than the respective surgeon such as as intensive care and anesthesia doctors. In our study, all percutaneous tracheostomies were performed by a skilled intensivist and were carried out at bedside in the intensive care

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