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Percutaneous Dilatational Tracheostomy for Emergent Airway Access

Division of General Internal Medicine, Cedars-Sinai Medical Center and University of California Los Angeles School of Medicine. Mark.Ault{at}cshs.org

Brian Ault

Division of General Internal Medicine, Cedars-Sinai Medical Center

Philip K. Ng, MD

Division of General Internal Medicine, Cedars-Sinai Medical Center and University of California Los Angeles School of Medicine

The study objective of this article was to evaluate percutaneous dilatational tracheostomy (PDT) for emergent airway access. This is a case series of 9 patients who presented over a 58-month period. All patients were in severe respiratory difficulty where intubation by conventional means was unsuccessful. All 9 patients were successfully intubated using PDT technique. No technical complications were noted, specifically bleeding, extratracheal placement, or prolonged procedure time. Six patients ultimately died, 2 from anoxic encephalopathy due to failed resuscitation and 4 from comorbid illness. Three patients ultimately survived to hospital discharge. The authors conclude that PDT can effectively establish a surgical airway in an emergent setting. The major advantage of this technique is the ability to gain and maintain competence in an elective, controlled environment. The authors believe that PDT may play a role in the management of the emergent surgical airway.

Key Words: tracheostomy • percutaneous • dilatational • ciaglia • emergency

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