High-Volume Tracheostomies in the Critically Ill Population: Analysis of Technique and Indications

Objectives:Analyze the frequency of and techniques used in performing tracheostomies. Understand the prevailing contraindications used in the decision between open versus percutaneous method. Evaluate outcomes among the 2 modes of tracheostomy procedures.Methods:Case-series review of all patients who underwent a tracheostomy spanning 4 years within a tertiary metropolitan hospital. Clinical and demographic data were used to compare the 2 groups of patients with respect to average age, hospital stay, related emergency department (ED) visits, and other complications.Results:A total of 1333 tracheostomies were performed on 1302 patients. This included 452 (34%) open versus 881 (66%) via the percutaneous dilatational technique (PDT). There was no difference in short-term complications between the 2 groups. The primary long-term complication, tracheal stenosis, occurred most commonly in the PDT group. The contraindications practiced in decision for open versus PDT are not uniform among the various services per...