PERCUTANEOUS DILATATIONAL TRACHEOSTOMY: A SELF-DRIVE CONTROL TECHNIQUE WITH VIDEO FIBEROPTIC BRONCHOSCOPY REDUCES PERIOPERATIVE COMPLICATIONS.

Aim of study: To demonstrate that performance of Percutaneous Dilatational Tracheostomy (PDT) associated with a self-drive control technique lowers the incidence of complications. Method: Case-control retrospective study Place of study: Major Teaching Hospital, Department of Emergency, Intensive Care Unit. Patients and methods: We studied 128 patients who underwent fiberoptic-guided PDT during a 18 months period of time. 39 patients were assisted by conventional fiberoptic broncoscopy, while on 89 video-assisted fiberoptic technique (VF) was performed to permit the operator to control his own actions on a screen. We defined perioperative complications: accidental extubation, perioperative haemorrhage, tracheal ring rupture, lesions of the tracheal wall, abnormal insertion of the cannula. Chi-square test, Student t-test and U Mann Whitney test were used to compare the incidence of complications and the duration of procedure in the traditional fiberoptic PDT group and in the video-guided one. Results: Time of procedure was significantly shorter in the group with the self-drive control technique; likewise there was a reduction of the number of perioperative complications. Conlusions: We conclude that fiberoptic broncoscopy associated with video system seems effective to reduce the risk of perioperative complications.