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Death after percutaneous dilatational tracheostomy: A systematic review and analysis of risk factors

Critical Care, ISSN: 1364-8535, Vol: 17, Issue: 5, Page: R258
2013
  • 143
    Citations
  • 0
    Usage
  • 148
    Captures
  • 4
    Mentions
  • 1
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    143
    • Citation Indexes
      138
    • Policy Citations
      3
      • Policy Citation
        3
    • Clinical Citations
      2
      • PubMed Guidelines
        2
  • Captures
    148
  • Mentions
    4
    • References
      3
      • Wikipedia
        3
    • News Mentions
      1
      • News
        1
  • Social Media
    1
    • Shares, Likes & Comments
      1
      • Facebook
        1

Most Recent News

Ultrasound Guided Percutaneous Tracheostomy

STUDY INFORMATION OFFICIAL TITLE: Comparison of 3 Techniques for Percutaneous Tracheostomy : Traditional Marking Technique, Ultrasonography Guided Long Axis Approach and Short Axis Approach CURRENT

Article Description

Introduction: Since the introduction and widespread acceptance of percutaneous techniques in the intensive care unit (ICU) setting, the number of critically ill patients undergoing tracheostomy has steadily increased. However, this procedure can be associated with major complications, including death. The purpose of this study is to estimate the incidence and analyze the causes of lethal complications due to percutaneous dilatational tracheostomy (PDT).Methods: We analyzed cases of lethal outcome due to complications from PDT including cases published between 1985 and April 2013. A systematic literature search was performed and unpublished cases from our own departmental records were retrospectively analyzed.Results: A total of 71 cases of lethal outcome following PDT were identified including 68 published cases and 3 of our own patients. The incidence of lethal complications was calculated to be 0.17%. Of the fatal complications, 31.0% occurred during the procedure and 49.3% within seven days of the procedure. The main causes of death were: hemorrhage (38.0%), airway complications (29.6%), tracheal perforation (15.5%), and pneumothorax (5.6%). We found specific risk factors for complications in 73.2% of patients, 25.4% of patients had more than one risk factor. Bronchoscopic guidance was used in only 46.5% of cases.Conclusions: According to this analysis, PDT-related death occurs in 1 out of 600 patients receiving a PDT. Careful patient selection, bronchoscopic guidance, and securing the tracheal cannula with sutures are likely to reduce complication rates. © 2013 Simon et al.; licensee BioMed Central Ltd.

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