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PercuTwist: a new alternative to Griggs and Ciaglia’s techniques

Published online by Cambridge University Press:  01 June 2007

N. Yurtseven ,
B. Aydemir ,
P. Karaca ,
T. Aksoy ,
G. Komurcu ,
M. Kurt ,
V. Ozkul  and
S. Canik
N. Yurtseven
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department ofAnesthesia and Reanimation, Istanbul, Turkey
B. Aydemir
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Thoracic Surgery, Istanbul, Turkey
P. Karaca
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Anadolu Foundation Health Care Center, Department of Anesthesia and Reanimation, Istanbul, Turkey
T. Aksoy*
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Maltepe University School of Medicine, Department of Anesthesia and Reanimation, Istanbul, Turkey
G. Komurcu
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiovascular Surgery, Istanbul, Turkey
M. Kurt
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department ofAnesthesia and Reanimation, Istanbul, Turkey
V. Ozkul
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department ofAnesthesia and Reanimation, Istanbul, Turkey
S. Canik
Affiliation:
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department ofAnesthesia and Reanimation, Istanbul, Turkey
*
Correspondence to: Dr Tamer Aksoy, Department of Anesthesia and Reanimation, Maltepe Universitesi Tip Fak., Ataturk Cad, Cam Sok. No 3 Maltepe, Istanbul 34170, Turkey. E-mail: tamermd@hotmail.com; Tel: +90 216 399 9750; Fax: +90 216 370 9719
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Summary

Background and objective

Tracheostomy is one of the most common procedures in intensive care units worldwide. In this study we aimed to compare three different tracheostomy techniques with respect to duration of procedure and complications.

Methods

One hundred and thirty patients requiring endotracheal intubation for more than 10 days due to acute respiratory distress syndrome, infections or cerebrovascular events were consecutively selected to undergo the percutaneous dilatational tracheostomy technique (PDT n = 44), the guide-wire dilating forceps technique group (GWDF n = 41) or the PercuTwist technique (n = 45). The time taken to perform the procedure (skin incision to successful placement of tracheostomy tube) and complications were recorded.

Results

The operating times were found to be 9.9 ± 1.1, 6.2 ±1.4 and 5.4 ± 1.2 min in PDT, GWDF and PercuTwist groups, respectively. The duration of the procedure was significantly shorter in the PercuTwist group as compared to the percutaneous dilatational tracheostomy (P < 0.01) and guide-wire dilating forceps (P < 0.05) groups. During postoperative bronchoscopy, eight cases of longitudinal tracheal abrasion (four in the PDT group, two in the GWDF group and two in the PercuTwist group), two cases of posterior tracheal wall injury (one in PDT and one in GWDF) and one case of tracheal ring rupture in the PDT group were seen.

Conclusions

Percutaneous tracheostomy techniques have their own advantages and complications. PercuTwist, a new controlled rotating dilatation method, was associated with minimal complications, appears to be easy to perform and a practical alternative to percutaneous dilatational tracheostomy and guide-wire dilating forceps techniques.

Keywords

TRACHEOSTOMY, percutaneousSURGICAL PROCEDURESCRITICAL CARE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 6 , June 2007 , pp. 492 - 497
Copyright
Copyright © European Society of Anaesthesiology 2006

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References

1.Jackson, C. Tracheostomy. Laryngoscope 1909; 19: 285–290.Google Scholar
2.Shelden, CH, Pudenz, RH, Tichy, FY. Percutaneous tracheostomy. JAMA 1957; 165: 2068–2070.CrossRefGoogle Scholar
3.Ciaglia, P, Firsching, R, Syniec, C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure: preliminary report. Chest 1985; 87: 715–719.Google Scholar
4.Griggs, WM, Worthley, LIG, Gilligan, JE, Thomas, PD, Myburg, JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet 1990; 170: 543–545.Google Scholar
5.Frova, G, Quintel, M. A new simple method for percutaneous tracheostomy: controlled rotating dilation. Int Care Med 2002; 28: 299–303.Google Scholar
6.Johnson, JL, Cheatham, ML, Sagraves, SG, Block, EF, Nelson, LD. Percutaneous dilational tracheostomy: a comparison of single-versus multiple-dilator techniques. Crit Care Med 2001; 29: 1251–1254.Google Scholar
7.Westphal, K, Maeser, D, Gert, S et al. . PercuTwist: a new single-dilator technique for percutaneous tracheostomy. Anesth Analg 2003; 96: 229–232.Google Scholar
8.Fikkers, BG, Staatsen, M, Lardenoije, S et al. . Comparison of two percutaneous tracheostomy techniques: guide wire dilating forceps and Ciaglia blue rhino: a sequential cohort study. Crit Care 2004; 8: 299–305.CrossRefGoogle Scholar
9.Chendrasekhar, A, Ponnapalli, S, Duncan, A. Percutaneous dilational tracheostomy: an alternative approach to surgical tracheostomy. South Med J 1995; 88: 1062–1064.Google Scholar
10.Bradley, D, Isabella, K, Lin, N et al. . A meta-analysis of prospective trials comparing percutaneous and surgical tracheostomy in critically ill patients. Chest 2000; 118: 1412–1418.Google Scholar
11.Friedman, Y, Fildes, J, Mizock, B et al. . Comparison of percutaneous and surgical tracheostomies. Chest 1996; 110: 480–485.Google Scholar
12.Bodenham, AR. Percutaneous dilatational tracheostomy, completing the anaesthetists range of airway techniques. Anaesthesia 1993; 48: 101–102.CrossRefGoogle ScholarPubMed
13.Cobean, R, Beals, M, Moss, C, Bredebberg, C. Percutaneous dilatational tracheostomy: a safe, cost-effective bedside procedure. Arc Surg 1996; 131: 265–271.Google Scholar
14Nates, JL, Cooper, J, Myles, PS et al. . Percutaneous tracheostomy in critically ill patients: a prospective, randomized comparison of two techniques. Crit Care Med 2000; 28: 3734–3739.CrossRefGoogle ScholarPubMed
15.Byhahn, C, Wilke, HJ, Lischke, V et al. . Bedside percutaneous tracheostomy: clinical comparison of Griggs and Fantoni techniques. World J Surg 2001; 25: 296–301.Google Scholar
16.Byhahn, C, Wilke, HJ, Halbig, S et al. . Percutaneous tracheostomy: Ciaglia Blue Rhino versus the basic Ciaglia technique of percutaneous dilational tracheostomy. Anesth Analg 2000; 91: 882–886.Google Scholar
17.Bewsher, MS, Adams, AM, Clarke, CW et al. . Evaluation of a new percutaneous dilatatioal tracheostomy set apparatus. Anaesthesia 2001; 56: 859.Google Scholar
18.Sengupta, N, Ang, KL, Prakash, D et al. . Twenty months routine use of a new percutaneous tracheostomy set using controlled rotating dilatation. Anesth Analg 2004; 99: 188–192.Google Scholar
19.Roberts, RG, Morgan, P, Findlay, GP. Percutaneous dilatational tracheostomy and tracheal ring rupture. Anaesthesia 2002; 57: 933–934.CrossRefGoogle ScholarPubMed
20.Scherrer, E. Tracheal ring fracture during a PercuTwist tracheostomy procedure. Anesth Analg 2004; 98: 1451–1453.Google Scholar
21.Anon, JM, Gomez, V, Escuela, MP et al. . Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care 2000; 4: 124–128.Google Scholar
22.Van Heurn, LW, Mastboom, WB, Scheeren, CL et al. . Comparative clinical trial of progressive dilatational tracheostomy. Intens Care Med 2001; 27: 292–295.Google Scholar