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- Title
Retrosternal percutaneous tracheostomy: an approach for predictably impossible classic tracheostomy.
- Authors
Biderman, Philippe; Weinbroum, Avi A.; Rafaeli, Yael; Raz, Eyal; Porat, Eyal; Wiesel, Ory; Szold, Oded
- Abstract
Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic tracheostomy is inapplicable. Retrosternal approach to tracheostomy in such 20 patients is herein reported. After preoperative neck computerized tomography to define the neck anatomy, a small suprasternal incision followed by a short retrosternal tissue dissection to expose the trachea was done; the trachea was then catheterized at the level of the 2nd ring in the usual tracheostomy manner. The immediate and late (≥6 months) outcomes were similar to that of the standard tracheostomy. Thus, percutaneous retrosternal tracheostomy is safe in patients with abnormal positioning of the trachea or neck constitution. It is a bedside applicable technique, that, however, requires caution to avoid hazardous vascular complications.
- Subjects
INTENSIVE care units; NUTRITION disorders; OBESITY; SURGERY; PATIENTS; TOMOGRAPHY; EATING disorders; METABOLIC disorders; WEIGHT loss
- Publication
Critical Care Research & Practice, 2010, p1
- ISSN
2090-1305
- Publication type
journal article
- DOI
10.1155/2010/397270