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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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