Percutaneous tracheostomy is a commonly carried out procedure in patients in
the Intensive Care Unit. Percutaneous dilatational tracheostomy consists of
the introduction of a tracheal cannula from the front of the neck, through
blunt dissection of the pretracheal tissues, using a guide by Seldinger
technique. When percutaneous dilatational tracheostomy procedure was
introduced in routine clinical practice in the Clinical Center of Vojvodina,
procedural protocol was established. This Protocol includes: 1. indications,
contraindications and timing for percutaneous dilatational tracheostomy, 2.
assessment of the patient, 3. preparation of the patient and equipment, 4.
procedure description, 5. potential complications and complication
management. At our institution percutaneous dilatational tracheostomy is
performed on an individual patient basis assessment within 5-7 days
following translaryngeal intubation. Routinely the platelet count,
activated prothrombin time and prothrombin time are checked. The patient?s
neck is assessed clinicaly and by the use of fiberoptic bronchoscope and
ultrasound. At our institution we use the modified Ciaglia technique of the
percutaneous dilatational tracheostomy-Ciaglia Single Dilatator method
with the TRACOE? experc Set vario which includes spiral rein?forced tracheal
cannula. At the end of procedure fiberoptic evaluation of the
tracheobroinchial tree is made and chest X-ray is done. Percutaneous
dilatational tracheostomy is a simple, safe, and effective procedure
performed in the Intensive Care Unit. It is the preferred technique of
airway management in the Intensive Care Units in the patients requiring
prolonged mechanical ventilation, tracheobronchial hygiene and weaning from
mechanical ventilation.
Use of the pro-seal laryngeal mask airway facilitates percutaneous dilatational tracheostomy in an intensive care unit
