Factors of Kornblith et al Conveying High Risk for a Patient Undergoing Bedside Percutaneous Tracheostomy in the Surgical Intensive Care Unit

 

Patient selection: surgical intensive care unit

 

A high risk patient had one or more of the following risk factors:

(1) cervical collar or halo

(2) traumatic injuries to the cervical spine

(3) systemic heparinization (or other anticoagulation)

(4) positive end-expiratory pressure (PEEP) > 10 cm H2O

(5) FIO2 > 50%

 

Most high risk patients have only one risk factor but 44% had 2 or more.

 

Early complications for the procedure (regardless of risk level):

(1) bleeding

(2) infection

(3) misplacement of the tracheostomy tube

(4) failure of procedure with need for cricothyroidotomy

 

Late complications:

(1) persistent stoma requiring surgical closure

(2) subglottic stenosis