• F Barrachina, J J Guardiola, T Añó, A Ochagavia, and J Mariné.
• Intensive Care Unit, Hospital Universitari Joan XXIII, Tarragona, Spain.
• Intensive Care Med. 1996 Sep 1; 22 (9): 937-40.

ObjectiveTo assess the value of the percutaneous dilatational technique in elective cricothyroidotomy.DesignForty-four consecutive patients requiring prolonged mechanical ventilation.SettingThe general 14-bed intensive care unit of a university hospital.InterventionsFourty-four percutaneous dilatational cricothyroidotomies using a multiple-dilator wire-guided procedure.Measurements And ResultsThe average duration for the procedure was 11 min in 37 patients. No significant complications occurred intraoperatively except for one paratracheal cannula insertion. Postoperative complications were one case of stoma infection, three cases of transient phonatory changes, two cases of a small peristomal granuloma, and one case of persistent stoma. Of 21 decannulated patients, 16 survived to discharge. Long-term follow-up was possible in 14 surviving patients. All were asymptomatic several months after decannulation.ConclusionsPercutaneous dilatational cricothyroidotomy can be a quick, safe technique, as good as the percutaneous subcricoidal approach in ventilated, critically ill patients.

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