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Background

Bedside percutaneous tracheostomy (BPT) is a cost-effective alternative to open tracheostomy. Small series have consistently documented minimal morbidity, but BPT has yet to be embraced as the standard of care. Because this has been our preferred technique in the surgical ICU for more than 20 years, we reviewed our experience to ascertain its safety. We hypothesize that BPT has acceptably minimal morbidity, even in high-risk patients.

Study Design

Patients undergoing BPT from January 1998 to June 2008 were reviewed. High-risk patients were defined as those with cervical collar or halo, cervical spine injuries, systemic heparinization, positive end-expiratory pressure> 10 cm H 2 O or fraction of inspired oxygen> 50%.

Results

During the study period, 1,000 patients underwent BPT (74% men; mean±SEM age 46±0.6 years; 70% trauma). BPT was performed 8.9±0.2 days (mean±SEM) after …