• M K Walz, K Peitgen, N Thürauf, H A Trost, U Wolfhard, A Sander, C Ahmadi, and F W Eigler.
• Department of General Surgery, Medical School, University of Essen, Germany.
• Intensive Care Med. 1998 Jul 1;24(7):685-90.

ObjectiveTo analyze perioperative and postoperative complications and long-term sequelae following percutaneous dilatational tracheostomy (PDT).DesignA prospective clinical study of patients undergoing PDT.SettingSeven intensive care units at a University hospitalPatients326 intensive care patients (202 male, 124 female; age: 11-95 years) with indications for tracheostomy.InterventionsUsing tracheoscopic guidance, 337 PDTs were performed according to Ciaglias' method. In 106 decannulated patients, tracheal narrowing was assessed by plain tracheal radiography.ResultsTwo procedure-related deaths were seen (0.6%). Perioperative and postoperative complications occurred with 9.5% of the PDTs. One of 106 patients, who were followed-up for at least 6 months, showed a clinically relevant tracheal stenosis. Subclinical tracheal stenosis of at least 10% of the cross-sectioned area was recognized in 46 of 106 patients (43.4%). In the univariate analysis, the degree of stenosis was influenced by the age of the patient (p = 0.044), the duration of intubation prior to PDT (p = 0.042) and by the duration of cannulation (p = 0.006). These parameters had no statistical significance in a multiple regression model.ConclusionWhen performed by experienced physicians, percutaneous dilatational tracheostomy under fiberoptic guidance is a safe method. The risks of early complications and of clinically relevant tracheal stenoses are low. Subclinical tracheal stenoses are found in about 40% of patients following PDT.

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