Retrosternal Percutaneous Tracheostomy: An Approach for Predictably Impossible Classic Tracheostomy

Autor: Philippe Biderman, Avi A. Weinbroum, Yael Rafaeli, Eyal Raz, Eyal Porat, Ory Wiesel, Oded Szold
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Zdroj: Critical Care Research and Practice, Vol 2010 (2010)
Druh dokumentu: article
ISSN: 2090-1305
2090-1313
DOI: 10.1155/2010/397270
Popis: Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic tracheostomy is inapplicable. Retrosternal approach to tracheostomy in such 20 patients is herein reported. After preoperative neck computerized tomography to define the neck anatomy, a small suprasternal incision followed by a short retrosternal tissue dissection to expose the trachea was done; the trachea was then catheterized at the level of the 2nd ring in the usual tracheostomy manner. The immediate and late (≥6 months) outcomes were similar to that of the standard tracheostomy. Thus, percutaneous retrosternal tracheostomy is safe in patients with abnormal positioning of the trachea or neck constitution. It is a bedside applicable technique, that, however, requires caution to avoid hazardous vascular complications.
Databáze: Directory of Open Access Journals