Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience

Purpose: To assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT). Materials and methods: A 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. Results: Two 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. Conclusion: GWB-PDT is a feasible and safe solution for tracheostomies in general-ward ventilated patients. (C) 2018 Elsevier Inc. All rights reserved.