부산대학교 도서관

Summary: Recently, percutaneous dilatational tracheotomy (PDT) has become more frequent, since the technique can be mastered relatively easily. PDT is neither time-consuming nor does it require much personell or material. Our study seeks to evaluate PDT in terms of its effectivness and practicality on a cardio-surgical ICU.40 patients underwent PDT on our cardio-surgical ICU. PDT was performed as described by Ciaglia using a bronchoscop. Mean operative time was 10 minutes (range 5–25 minutes). During PDT the oxygenation index (pO2/FiO2) fell by an average of 10%. Complications such as emphysema, aspiration or bleeding were noted in 5 patients. There were no deaths attributable to PDT. Likewise, there were no cases of infection of the tracheotomy or tracheal stenoses. Since the oxygenation index falls during PDT, the technique should only be used in patients with an oxygenation index over 100 and an FiO2 of at least 0.8 (80% oxygen) to avoid hypoxic sequelae. Based on our experience were believe that PDT is safe only in the hands of a physician who is well versed in both anatomy and the technique of conventional tracheotomy.