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  • Title: [Fiberoptic bronchoscopy assisted percutaneous tracheostomy: report of 100 patients].
    Author: Romero P C, Cornejo R R, Ruiz C M, Gálvez A R, Llanos V O, Tobar A E, Larrondo G J, Castro O J.
    Journal: Rev Med Chil; 2008 Sep; 136(9):1113-20. PubMed ID: 19030654.
    Abstract:
    BACKGROUND: Development of percutaneous techniques for tracheostomy have facilitated its implementation in the intensive care unit (ICU). AIM: To evaluate the safety of performing percutaneous tracheostomy (PT) using the Ciaglia Blue Rhino technique with fiberoptic bronchoscopy assistance in patients with prolonged mechanical ventilation. PATIENTS AND METHODS: Prospective evaluation of 100 consecutive patients aged 62+/-16 years (38 women) subjected to percutaneous tracheostomy. All the procedures were performed in the ICU. Demographic variables, APACHE II, days of mechanical ventilation before PT, operative and post-operative complications were recorded. RESULTS: Mean APACHE II score was 20+/-3. Patients required on average 16+/-7 days of mechanical ventilation before PT. Eight patients (8%) had operative complications. One had an episode of transitory desaturation, one had a transitory hypotension related to sedation and six had mild bleeding not requiring transfusion. No patient required conversion to surgical tracheostomy. Four patients (4%) presented post-operative complications. Two had a mild and transitory bleeding of the ostomy and two had a displacement of the cannula. No other complications were observed. CONCLUSIONS: PT using the Ciaglia Blue Rhino technique with fiberoptic bronchoscopy assistance is a safe procedure that can be performed in the ICU by trained intensivists.
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