Chest
Volume 119, Issue 4, April 2001, Pages 1282-1283
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Selected Reports
Complications of Percutaneous Tracheostomy

https://doi.org/10.1378/chest.119.4.1282Get rights and content

Percutaneous tracheostomy is a technique that, reputedly, is simple to perform and causes few complications. It is routinely used in intensive care. We present two patients with tracheal stenosis. In one patient, we had to perform an anastomotic resection to cure the patient; in the other patient, we had to place an endoluminal conformer. To our knowledge, this complication has not been reported in association with the use of this technique.

Section snippets

Case 1

A 33-year-old immunocompetent female patient was hospitalized in the emergency department after the rupture of an intracerebral angioma. Percutaneous tracheostomy was performed at 14 days. The endoscopy performed 9 days later showed no abnormality in the trachea. At 30 days, glottic edema developed, but it was difficult to assess the portion below the tracheal tube because the patient was agitated. Extubation was considered at 40 days, as the patient's neurologic and respiratory condition had

Discussion

Percutaneous tracheostomy is a technique that seems to be simple to perform and causes fewer complications than conventional tracheostomy. Two techniques are proposed: the Ciaglia method,1 with gradual dilatation of the trachea after puncture (which seems to be the most reliable method); and the less frequently used Fantoni method,2 a translaryngeal method where the tube is placed, through the vocal cords, on the anterior side of the trachea. In our hospital, the ICU department uses the Ciaglia

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