Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by a Neurointensivist Compared with Conventional Surgical Tracheostomy in Neurosurgery Intensive Care Unit

Abstract

A total of 118 patients underwent tracheostomy during the study period. Elective surgery of brain tumor (33.1%) and intracranial hemorrhage (20.3%) were the most common reasons for ICU admission. Prolonged intubation (42.4%) and airway protection or prevent risk of aspiration (25.4%) were the most common reasons for tracheostomy. There was no significant difference in initial success rate of tracheostomy between the two groups (p=0.110). However, procedural time was lengthier in CST than that in PDT (39.0 [30.0–60.0] min vs. 15.0 [11.0–23.0] min, p<0.001). Procedure-induced complications were more common in patients who underwent CST compared to those in patients who underwent PDT (26.3% vs. 11.5%, p=0.039). Although moderate or major bleeding occurred in five patients who underwent CST, only one patient had moderate bleeding in PDT. Especially, there were two respiratory arrests during procedure in CST. In addition, two VAPs and seven wound infections occurred in CST.