Comparison of Percutaneous Dilatational Tracheostomy via Fiberoptic Bronchoscopy with Standard Percutaneous Dilatational Tracheostomy: A Prospective Randomized Trial

Abstract

Aim:The aim of this study was to compare the procedure duration and complications of standard percutaneous dilatational tracheostomy (PDT) with PDT via fiberoptic bronchoscopy.Methods:Patients over 18 years of age who were dependent on mechanical ventilation were included in this prospective study. The patients were divided into two groups as PDT (group F, n=28) performed by using fiberoptic bronchoscopy and standard PDT (group S, n=30) performed without fiberoptic bronchoscopy. Age, gender, cause of hospitalization, hemogram, blood gas values, duration of tracheostomy and complications during and after the procedure were recorded in all patients.Results:A total of 58 patients were included in the study. Twenty-one (36.2%) patients were female. There was no difference between the two groups in terms of demographic characteristics except age, and laboratory values (p=0.006). The most common cause of hospitalization were respiratory diseases in both groups (28.6% in group F, and 40% in group S). There was no difference in the duration of the procedure (6.07±4.72 and 7.50±1.79 minutes in group F and group S, respectively (p=0.12). The most common postoperative complications were minor bleeding (28.5% in group F and 43.3% in group S) and bleeding around the stoma (21.4% in group F and 20% in group S), respectively. None of the patients had pneumothorax, subcutaneous emphysema, major bleeding, or tracheal posterior wall damage.Conclusion:In our study, there was no difference in terms of procedure duration and early complications between patients undergoing PDT with and without bronchoscopy. In the tracheostomy procedure, the method to be used should be decided by considering the patient’s condition and the materials available to the practitioner.

Keywords

• percutaneous tracheostomy
• bronchoscopy
• intensive care