Percutaneous Tracheostomy: Indications, Complications and Techniques

Percutaneous Tracheostomy has become the preferred method of tracheostomy placement in critically ill patients. The most common indications are prolonged mechanical ventilation and inability to protect the airway. The procedure is safe, simple and is easily performed by non-surgical providers. It has advantages over surgical tracheostomy in terms of fewer stoma infections and decreased costs. The most widely used method of performing percutaneous dilatational tracheostomy is the single dilator method (Ciaglia Blue Rhino). Although there are several other techniques, the single dilator method has the most experience and best safety profile. The use of bronchoscopy and ultrasound as adjuncts facilitates placement of the tracheostomy tube, minimizes complications and enhances patient safety.

Keywords: Bleeding, Bronchoscopy, Ciaglia Blue Rhino, Complications of Tracheostomy, Percutaneous Dilatational Tracheostomy, Posterior Tracheal Injury, Prolonged Mechanical Ventilation, Respiratory Failure, Single Dilation Technique, Surgical Tracheostomy, Tracheal Stenosis, Ultrasound.