[Fiberoptic bronchoscopy assisted percutaneous tracheostomy: report of 100 patients].

BACKGROUND: Development of percutaneous techniques for tracheostomy have facilitated its implementation in the intensive care unit (ICU).

AIM: To evaluate the safety of performing percutaneous tracheostomy (PT) using the Ciaglia Blue Rhino technique with fiberoptic bronchoscopy assistance in patients with prolonged mechanical ventilation.

PATIENTS AND METHODS: Prospective evaluation of 100 consecutive patients aged 62+/-16 years (38 women) subjected to percutaneous tracheostomy. All the procedures were performed in the ICU. Demographic variables, APACHE II, days of mechanical ventilation before PT, operative and post-operative complications were recorded.

RESULTS: Mean APACHE II score was 20+/-3. Patients required on average 16+/-7 days of mechanical ventilation before PT. Eight patients (8%) had operative complications. One had an episode of transitory desaturation, one had a transitory hypotension related to sedation and six had mild bleeding not requiring transfusion. No patient required conversion to surgical tracheostomy. Four patients (4%) presented post-operative complications. Two had a mild and transitory bleeding of the ostomy and two had a displacement of the cannula. No other complications were observed.

CONCLUSIONS: PT using the Ciaglia Blue Rhino technique with fiberoptic bronchoscopy assistance is a safe procedure that can be performed in the ICU by trained intensivists.