• Oded Cohen, Ruth Shnipper, Liron Yosef, Dekel Stavi, Yael Shapira-Galitz, Moshe Hain, Yonatan Lahav, Hagit Shoffel-Havakuk, Doron Halperin, and Nimrod Adi.
• Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel. Electronic address: odedco@clalit.org.il.
• J Crit Care. 2018 Oct 1; 47: 127-132.

PurposeTo assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT).Materials And MethodsA retrospective study of all patients who underwent elective GWB-PDT between 2009 and 2015. A joint otolaryngology-ICU team performed all GWB-PDTs. The patients were followed until decannulation, discharge or death. Complications were divided into early (within 24 h) and late, and into minor and major.ResultsTwo hundred and fifty six patients were included in the study. The mean age was 77.7 ± 11.8 Medical history included cardiac comorbidities (42.6%) and cerebrovascular accidents (34.4%). Overall, 48 patients (18.9%) had 60 complications, of which 70% (42/60) were minor (13 early; 29 late complications). Fifteen patients (5.9%) had major complications. Eight patients had early major complications (loss of airway - two patients [0.8%], pneumothorax - two patients [0.8%], resuscitation - one patient [0.4%], and a single patient (0.4%) died within 24 h following PDT). Two additional patients (0.8%) underwent conversion to an open tracheostomy. Seven patients had late complications (airway complications in six patients [2.3%] and major bleeding in a single patient [0.4%]). Of the seven patients with late major complications, three had two major complications. Half of the complications occurred by POD 3.ConclusionGWB-PDT is a feasible and safe solution for tracheostomies in general-ward ventilated patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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