• Jindrich Lukas, Jaroslava Duskova, David Lukas, Jan Paska, Martin Stritesky, and Tomas Haas.
• Department of Otolaryngology, Head and Neck Surgery, College Tutor, Nemocnice Na Homolce, Roentgenova 2, Praha 5, Czech Republic. jluk@seznam.cz
• Saudi Med J. 2007 Oct 1;28(10):1529-33.

ObjectiveThe present prospective randomized trial compared surgical tracheostomy (ST) and percutaneous dilatational tracheostomy (PDT) in intensive care unit (ICU) patients in terms of outcomes and complications.MethodsBetween January 2003 and December 2005 tracheostomies were performed on critically ill ICU patients in Medical Faculty Hospital in Prague, with a random allocation of 105 patients for ST and 100 for PDT.ResultsThe 2 groups did not differ significantly in terms of basic demographic characteristics or length of endotracheal intubation prior to the procedure. Following the procedures, the 2 groups did not differ significantly in terms of the time required for decannulation, decannulated patients or mortalities. Post-mortem examination showed that both groups were similar in terms of placement of the tracheostomy tube. Surgical tracheostomy was found to take longer time to perform than PDT (p<0.001). In terms of early postoperative complications, PDT was associated with a higher rate of postoperative bleeding compared to ST (p=0.0302).ConclusionPercutaneous dilatational tracheostomy is a simpler and faster technique to perform, but is associated with a higher occurrence of early complications, particularly postoperative bleeding.

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