Safety of bedside percutaneous dilatational tracheostomy in obese patients in the ICU

Study objective: To examine the safety of bedside percutaneous dilatational tracheostomy in obese patients, Design: Case series of consecutive obese patients (body mass index greater than or equal to 27 kg/m(2)) with acute respiratory failure in a medical, cardiac, or surgical ICU unit who required tracheostomy for failure to wean and continued mechanical ventilatory support. Results: Thirteen obese patients were identified and consented to the procedure. Bedside percutaneous dilatational tracheostomy was successfully performed in the ICU for all 13 patients. Procedural complications were limited to paratracheal tracheostomy tube placement in one patient, with immediate identification and appropriate correction. Postprocedural complications were limited to a cuff leak in one patient. Conclusion: Bedside percutaneous tracheostomy can be safely performed in obese patients.