Update 2000: Tracheostomy on German intensive care units

A questionnaire was sent to German intensive care units (ICU) requesting information with regard to frequency, technique, and the medical/surgical specialties performing tracheostomies on these units. In July 1999, a total of 1,408 hospitals with a department of anaesthesia received a questionnaire. Information was sought regarding size of hospital and ICU, number of beds with respirators, medical/surgical specialty in charge of the ICU, as well as frequency, technique, and place of tracheostomy, 963 of the questionnaires were answered. 76.7% came from hospitals with up to 500 beds, 12.9% from hospitals with 500-749 beds, 3.3% from institutions of 750 to 1,000 beds, and 7.0% were returned from hospital centers with over 1,000 beds. Our data showed that currently about 31,600 tracheostomies are performed on German ICU's, of these 51.3% are percutaneous tracheostomies, Ciaglia's percutaneous dilatational technique (PDT) is most commonly employed (56.6%). Conventional surgical tracheostomy is usually done in the operating room (83.0%) by a surgeon (67.9%), while percutaneous tracheostomies are usually performed at the patient's bedside on the ICU (86.3%) by an anaesthesiologist (75.5%). Our data shows that one of the most common surgical procedure in critically ill patients - tracheostomy - is undergoing rapid change. On the one hand, percutaneous tracheostomy techniques are becoming more common, on the other hand non-surgeons, especially anaesthesiologists, are increasingly performing the procedure.