Unassisted percutaneous tracheostomy: A new flow chart decision making based on simple physical conditions

Abstract Introduction Percutaneous dilatation tracheostomy (PDT) has several advantages over traditional surgical tracheostomy. However, it is still performed using bronchoscopy guidance. Objective To suggest the safety of unassisted PDT, without bronchoscopy guidance, based on bed–side screening flow chart evaluation. Material and methods 180 consecutive UCI patients referred to tracheostomy were submitted to Avalo's Screening Chart (ASC), in order to decide surgical technique. Results 161 patients were referred to unassisted PDT (un PDT) and 19 to surgical tracheostomy (ST) due to nonfulfillment of ASC steps. 10 patients submitted to unassisted PDT presented early complications, 8 presented mild bleeding and 2 false tracts. None of 6 months follow up patients presented long term complications. Conclusion The authors suggest unPDT is a safety surgical method in UCI patients who were submitted and approved to an easy anatomical and clinical screening chart (ASC).