XXXX Fracture Secondary to Percutaneous Tracheostomy: Is Tracheal Flaccidity a Risk Factor?

@entity1 @entity174 @entity2421 @entity397 @entity8276
OBJECTIVE: To evaluate the risk factors of @entity174 and whether previous @entity8276 flaccidity predisposes to it in consecutive, mechanically ventilated, intensive care unit @entity1 undergoing different percutaneous dilatational tracheostomy procedures (Ciaglia Blue Rhino, PercuTwist, and Ciaglia BlueDolphin). DESIGN: Single-center retrospective study performed between November 2006 and July 2013. SETTING: Single-center university hospital. @entity1 : Two hundred nineteen consecutive intensive care unit @entity1 . INTERVENTIONS: Video bronchoscopic percutaneous dilatational tracheostomies using different techniques, including Ciaglia Blue Rhino, PercuTwist, and Ciaglia BlueDolphin, were performed consecutively. During the procedure, the tracheal wall response to the routine external palpation was evaluated endoscopically to find the interanular space. An abnormal change in the @entity8276 shape (fingerprint) with anterior airway wall collapse was diagnosed as @entity2421 . MEASUREMENTS AND MAIN RESULTS: @entity174 occurred in 21 @entity1 (9.6%). The proportion of @entity397 was 16 (76.2%) after PercuTwist, 3 (14.3%) after Ciaglia Blue Dolphin, and 2 (9.5%) after the Blue Rhino technique. Significant risk factors for @entity397 were PercuTwist procedure (p = 0.02), @entity2421 (p = 0.0001), and a period of intubation before a percutaneous dilatational tracheostomy procedure>14 days (p = 0.01). CONCLUSIONS: In addition to the PercuTwist technique and intubation>14 days before tracheostomy, @entity2421 was a significant risk factor for @entity174 . In the presence of this finding, a less traumatic tracheostomy procedure should be applied.
