Intensive Care Medicine

, Volume 22, Issue 9, pp 937–940 | Cite as

Percutaneous dilatational cricothyroidotomy: Outcome with 44 consecutive patients

  • F. Barrachina
  • J. J. Guardiola
  • T. Añó
  • A. Ochagavia
  • J. Mariné



To assess the value of the percutaneous dilatational technique in elective cricothyroidotomy.


Forty-four consecutive patients requiring prolonged mechanical ventilation.


The general 14-bed intensive care unit of a university hospital.


Fourty-four percutaneous dilatational cricothyroidotomies using a multiple-dilator wire-guided procedure.

Measurements and results

The average duration for the procedure was 11 min in 37 patients. No significant complications occurred intraoperatively except for one paratracheal cannula insertion. Postoperative complications were one case of stoma infection, three cases of transient phonatory changes, two cases of a small peristomal granuloma, and one case of persistent stoma. Of 21 decannulated patients, 16 survived to discharge. Long-term follow-up was possible in 14 surviving patients. All were asymptomatic several months after decannulation.


Percutaneous dilatational cricothyroidotomy can be a quick, safe technique, as good as the percutaneous subcricoidal approach in ventilated, critically ill patients.

Key words

Cricothyroidotomy Critically ill patients Mechanical ventilation Percutaneous Tracheotomy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Brantigan CO, Grow JB (1976) Cricothyroidotomy: elective use in respiratory problems requiring tracheotomy. J Thorac Cardiovasc Surg 71:79–80Google Scholar
  2. 2.
    Morain WD (1980) Cricothyroidotomy in head and neck surgery. Plast Reconstr Surg 65(4):424–428PubMedGoogle Scholar
  3. 3.
    Greisz H, Qvarnström O, Willén R (1982) Elective cricothyroidotomy: a clinical and histopathological study. Crit Care Med 10:387–389PubMedGoogle Scholar
  4. 4.
    Holst G, Hedenstierna G, Kumlien JA, Schiratzki H (1985) Five years experience of coniotmy. Intensive Care Med 11:202–206PubMedGoogle Scholar
  5. 5.
    Van Hasselt E, Bruining H, Hoeve L (1985) Elective cricothyroidotomy. Intensive Care Med 11:207–209PubMedGoogle Scholar
  6. 6.
    Cole RR, Aguilar EA (1988) Cricothyroidotomy versus tracheotomy: an otolaryngologist's perspective. Laryngoscope 98:131–135PubMedGoogle Scholar
  7. 7.
    Kuriloff DB, Setzen M, Portnoy W, Gadaleta D (1989) Laryngotracheal injury following cricothyroidotomy. Laryngoscope 99:125–130PubMedGoogle Scholar
  8. 8.
    Hazard P, Jones C, Benitone J (1991) Comparative clinical trial of standard operative tracheostomy with percutaneous tracheostomy. Crit Care Med 19:1018–1024PubMedGoogle Scholar
  9. 9.
    Griggs WM, Myburgh JA, Worthley LI (1991). A prospective comparison of a percutaneous tracheostomy technique with standard surgical tracheostomy. Intensive Care Med 17:261–263CrossRefPubMedGoogle Scholar
  10. 10.
    Hazard PB, Garrett HE Jr, Adams JW, Robbins ET, Aguillard RN (1988) Bedside percutaneous tracheostomy: experience with 55 elective procedures. Ann Thorac Surg 46:63–67PubMedGoogle Scholar
  11. 11.
    Ciaglia P, Graniero KD (1992) Percutaneous dilatational tracheostomy: results and long-term follow-up. Chest 101:464–467PubMedGoogle Scholar
  12. 12.
    Freidman Y, Mayer AD (1993) Bedside percutaneous tracheostomy in critical ill patients. Chest 104:532–535PubMedGoogle Scholar
  13. 13.
    Toursarkissian B, Zweng N, Kearney PA, Pofahl WE, Johnson SB, Barker DE (1994) Percutaneous dilational tracheostomy: report of 141 cases. Ann Thorac Surg 57:862–867PubMedGoogle Scholar
  14. 14.
    Jiménez M, Pascual R, De la Casa S, Yus S, Lopez J, Arce MA (1994) Traqueotomía percutánea: experiencia en 57 casos en nuestra unidad de Cuidados Intensivos. Med Intensiva 18:199–202Google Scholar
  15. 15.
    Rubio JJ, Chamorro JM, Mas MA, Estecha MA, Molina JM, Mas M (1994) Traqueotomía percutánea electiva an cuidados intensivos: experiencia con 51 casos. Med Intensiva 18: 203–206Google Scholar
  16. 16.
    Ciaglia P, Firsching R, Syniec C (1985) Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest 87:715–719PubMedGoogle Scholar
  17. 17.
    Toye FJ, Weinstein JD (1986) Clinical experience with percutaneous dilatational tracheostomy and cricothyroidotomy in 100 patients. J Trauma 6: 1034–1040Google Scholar
  18. 18.
    Schachner A, Ovil J, Sidi J, Rogev M, Heilbronn Y, Levy MJ (1989) Percutaneous tracheostomy — a new method. Crit Care Med 17:1052–1056PubMedGoogle Scholar
  19. 19.
    Schachner A, Ovil J, Sidi J, Avram A, Levy MJ (1990) Rapid percutaneous tracheostomy. Chest 98:1266–1270PubMedGoogle Scholar
  20. 20.
    Hutchison RC, Mitchell RD (1991) Life-threatening complications from percutaneous dilatational tracheostomy. Crit Care Med 19:118–120PubMedGoogle Scholar
  21. 21.
    Pau A, Marelli D, Chiu CJ, Vestweber KH, Mulder DS (1989) Percutaneous endoscopic tracheostomy. Ann Thorac Surg 47:314–315PubMedGoogle Scholar
  22. 22.
    Marelli D, Paul A, Manolidis S, Walsh G, Odim JNK, Burdon TA et al (1990) Endoscopic guided percutaneous tracheostomy: early results of a consecutive trial. J Trauma 30:433–435PubMedGoogle Scholar
  23. 23.
    Winkler WB, Barnik R, Seelmann O, Haulicek J, Slany J (1994) Bedside percutaneous dilational tracheostomy with endoscopic guidance: experience with 71 ICU patients. Intensive Care Med 20:476–479CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • F. Barrachina
    • 1
    • 3
  • J. J. Guardiola
    • 1
  • T. Añó
    • 2
  • A. Ochagavia
    • 1
  • J. Mariné
    • 1
  1. 1.Intensive Care UnitHospital Universitari “Joan XXIII”TarragonaSpain
  2. 2.Department of OtorhinolaringologyHospital Universitari “Joan XXIII”TarragonaSpain
  3. 3.BenicarlóSpain

Personalised recommendations