Comparison of Conventional Surgical Tracheostomy and Percutaneous Dilatational Tracheostomy in the Intensive Care Unit

Abstract

Background: Percutaneous dilatation tracheostomy (PDT) is a minimally invasive and blind procedure, whereas conventional surgical tracheostomy (CST) is an open procedure. CST is accompanied by intraoperative and postoperative complications, whereas PDT can reduce the associated risks and has the benefits of reducing costs and being relatively simple.
Objective: To compare between CST and PDT in ICU.
Design: Retrospective research.
Setting: The Intensive care unit (ICU) at Kuwait Hospital Sharjah (KHS).
Patients and Methods: The patients enrolled were those who underwent PDT by intensivists, and patients who underwent CST performed by ENT physicians. The collection of data related to PDT cases was done from October 2021 to September 2023, whereas that of CST cases was done from January 2018 to July 2021. The collected data included demographics, laboratory tests, comorbidities, and outcomes.
Main outcomes and measure: Recovery, adverse outcomes and complications were the primary outcomes, where adverse outcomes, included mortality.
Sample size: 110 subjects, where categorized into 55 subjects in PDT and 55 subjects in CST group.
Results: There was age, gender, and APACHEII match between both groups. Significant variations were found between both groups regarding delay time (P= .001), airway protection indication (P= .002), bleeding (P= .01), bleeding diathesis (P= .02), and days of mechanical ventilation (P˂ .001).
Conclusion: PDT was superior to CST regarding delay time, mechanical ventilation days, bleeding, and usage of blood and blood components. However, both interventions displayed no superiority regarding mortality and length of stay.