Percutaneous Tracheostomy In ICU

Описание

Tracheostomy is one of the oldest procedures known to mankind. In this technique a hole is made in the anterior part of trachea in the neck. Tracheostomy can be done either surgically or percutaneously. Surgical technique is traditional one in which neck is dissected layer by layer through a skin incision and stoma is created. This is performed by a surgeon in OT and sometimes bedside. Percutaneous technique is a novel technique, which was introduced in 1985. Compared to surgical technique, the percutaneous dilatational tracheostomy (PDT) uses a modified Seldinger technique where the trachea is accessed with a needle and then a guidewire is inserted.

Initially, the serial dilator technique was introduced where sequentially larger dilators were used to create a stoma. Later, instead of serial dilators, a single curved tapering dilator was introduced to dilate the stoma in one single step, which is now most commonly used. The use of a single dilator has minimized complications associated with serial dilation that were seen at the outset.
A technique introduced in 1997 uses a specially designed Griggs forceps to dilate the stoma that is introduced over a guidewire and then extended to dilate the stoma.