ABSTRACT

Percutaneous dilatational tracheostomy (PDT) is indicated when prolonged mechanical ventilation is required. Although tracheostomy has only been applied by surgical techniques in the recent past, it is currently applied using PDT techniques. PDT is performed in a short time; it is a simple technique with a low complication rate and a smaller skin incision, and it can be performed at the patient’s bedside. Elderly individuals comprise an increasing proportion of the population and represent a progressively expanding number of patients admitted to the intensive care unit (ICU) who require prolonged mechanical ventilation; thus, the number of tracheotomy procedures is ultimately increasing. In this study, we aimed to present our PDT practices in the elderly in our ICU.

After obtaining ethics committee approval, we conducted a retrospective chart review of 47 geriatric patients in the ICU who underwent PDT by an anaesthesiologist.

Eighteen patients died (38%) during hospitalization in the general ICU (of causes unrelated to PDT). Sixteen patients were successfully weaned from mechanical ventilation following PDT. The mean time interval from PDT to weaning from mechanical ventilation was 9.56±6.35 days (range: 1–23 days). Fourteen patients were discharged from the general ICU with tracheostomy cannulae, and five patients were discharged with household ventilators. The mean time interval from PDT to discharge from ICU was 24.00±11.86 days (range 5–45 days).

The Griggs technique for PDT appears to be safe when performed by anesthesiologists or intensive care physicians. It can be performed easily at the patient’s bedside; thus, the transport of critically ill patients, especially geriatric patients, to the operating room can be averted.