• Respiration · Jan 2012

    Safety and efficiency of interventional pulmonologists performing percutaneous tracheostomy.

    • Lonny Yarmus, Vinciya Pandian, Christopher Gilbert, Adam Schiavi, Adil Haider, Albert Chi, Athir Morad, Christina Miller, David Efron, Kent Stevens, Shravani Gangidi, Ravi Vaswani, Elliott Haut, Marek Mirski, Nasir Bhatti, and David Feller-Kopman.
    • Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, The Johns Hopkins University, Baltimore, MD 21205, USA. lyarmus@jhmi.edu
    • Respiration. 2012 Jan 1; 84 (2): 123-7.

    BackgroundThe steady rise in the number of critically ill patients in the USA has led to an increase in the need for tracheostomies in patients requiring chronic ventilatory support. There is a matched need for experienced operators to safely and efficiently perform these procedures.ObjectivesWe evaluated the effects on procedural outcomes and efficiency of percutaneous dilatational tracheostomy (PDT) placement in the medical intensive care unit (MICU) by the surgical team (ST) or interventional pulmonologists (IP). The IP team joined the PDT team in September 2007 and became primarily responsible for all PDT in the MICU.MethodsA retrospective analysis of prospectively collected data of patients who received PDT in the MICU by ST and IP from September 2007 to August 2010 was made. Outcomes including safety, efficacy, and procedural efficiency were compared.ResultsOne hundred seven patients underwent bedside PDT in the MICU during this period. Forty-three procedures (40.2%) were performed by the ST and 64 procedures (59.8%) were performed by IP. There was no statistical difference between the incidence of airway injury and infection between the two procedural groups. There were no deaths related to the performance of PDT in our series. PDT was completed within 48 h of request in 100% of IP patients and 95% of ST patients (p = 0.08).ConclusionsThere were no statistical differences in PDT between the ST and IP groups when comparing complications. There was a trend towards an increased efficiency in time to PDT after consultation within the IP PDT group. Trained IP can safely and effectively perform PDT.Copyright © 2012 S. Karger AG, Basel.

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