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Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Percutaneous dilatational tracheostomy (PDT) is a standard procedure routinely performed on intensive care units. While complication rates and long-term outcomes have been studied in different patient populations, there are few studies known to these authors involving PDT in trauma patients and the complications which may result.

Methods

Between March 2007 and August 2013, all instances and peri-procedural complications during PDT occurring on the trauma intensive care unit, a unit specialized in the care of injured patients and especially polytrauma patients, were documented. PDTs were performed by a surgeon with the assistance and supervision of another, using bronchoscopic guidance performed by the respiratory medicine department.

Results

289 patients were included in the study, 225 men and 64 women with a mean age of 49 ± 21 years. Complications occurred in 37.4 % of cases. The most common complication, bleeding, occurred in 26.3 % of patients ranging from little to severe bleeding. Fracture of tracheal cartilage occurred in 6 % of PDT cases. Additional complications such as dislocation of the guidewire, hypotension, and oxygen desaturation were observed. Most complications did not require treatment. The second tracheal intercartilaginous space was successfully intubated in 82 % of cases.

Conclusions

PDT is a safe procedure in trauma patients. When considering the severity of complications such as major blood loss, pneumothorax, or death, this evidence suggests that PDT is safer in trauma patients compared to other patient cohorts.

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Authors and Affiliations

  1. Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    S. Decker, D. L. Cruz, C. W. Müller, C. Krettek & M. Wilhelmi

  2. Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany

    J. Gottlieb

  3. Division for Cardiac, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany

    M. Wilhelmi

Authors
  1. S. Decker
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  2. J. Gottlieb
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  3. D. L. Cruz
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  4. C. W. Müller
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  5. M. Wilhelmi
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  6. C. Krettek
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  7. M. Wilhelmi
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Corresponding author

Correspondence to S. Decker.

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Conflict of interest

Sebastian Decker, Jens Gottlieb, Dana Leslie Cruz, Christian Walter Müller, Mathias Wilhelmi, Christian Krettek, and Michaela Wilhelmi declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Decker, S., Gottlieb, J., Cruz, D.L. et al. Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure. Eur J Trauma Emerg Surg 42, 605–610 (2016). https://doi.org/10.1007/s00068-015-0578-9

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  • DOI: https://doi.org/10.1007/s00068-015-0578-9

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