Abstract

RAMIREZ- ARCE, Jorge A; PADILLA- CUADRA, Juan I.  and  SANCHEZ- ARIAS, Mario. Traqueostomía percutánea por dilatación: Reporte de 70 casos. Acta méd. costarric [online]. 2006, vol.48, n.2, pp.77-83. ISSN 0001-6002.

Tracheostomy is the most common surgical procedure performed in critical care patients. In the last few years, a technique known as percutaneous dilational tracheostomy guided by bronchoscopy was introduced. We present our experience with this procedure at the Hospital R.A. Calderón Guardia, San José Costa Rica. Materials and method: A percutaneous tracheostomy was perform in 70 patients between august 2002 and october 2004 at the Critical Care Unit of the Hospital Dr. Rafael Angel Calderón Guardia. The procedure was performed following a modification of the Ciaglia technique. Epidemiological data and complications were collected. Results: Eighty percent were men and 20 % women. The main complications were transient low oxygen saturation (7.14 %), tracheal ring fracture (4.2 %), bronchoscope puncture (4.2 %), unplanned extubation (2.85%) and mild bleeding (2.85%). Average surgical time was 8.14 minutes. There was no mortality associated with the procedure. Conclusion: This technique is safe and can be performed by medical intensivists. There should be a multidisciplinary team to support the performance of this procedure. Percutaneous tracheostomy should be the first choice technique for tracheostomy in the critical care unit.

Keywords : percutaneous tracheostomy; branchoscopy; intensive care.