The guide wire dilating forceps technique of percutaneous tracheostomy

Background: Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. Methods: In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. Results: Most percutaneous tracheostomies were performed without any adverse effect. No life-threatening complications or deaths were related to the procedure. The procedure was successful in 49 of 50 patients (98%). In 1 patient the procedure was converted to an open tracheostomy because significant bleeding occurred. Five perioperative complications, including this significant bleeding and four minor complications, occurred in 50 patients (10%). Early complications occurred in 6 of 48 patients (13%), including one significant bleeding and five minor complications. A subglottic stenosis occurred in 2 of 36 successfully decannulated patients (6%). In one case this was certainly due to prolonged endotracheal intubation. Conclusions: The GWDF technique is a safe and efficient bedside alternative to open tracheostomy. Fiberscopic control is recommended to increase the safety of the procedure. Although studies of late complications are necessary, it appears to be justifiable to consider percutaneous tracheostomy for patients who require tracheostomy.