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Role of cricothyrotomy and percutaneous tracheostomy in airway management

Mat Nor, Mohd. Basri (2012) Role of cricothyrotomy and percutaneous tracheostomy in airway management. In: 2nd IIUM Airway Management Scientific Meeting 2012, 1st-2nd Nov. 2012, Kuantan, Pahang.

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Abstract

Since Ciaglia et al described the percutaneous dilational tracheostomy in 1985, PDT has gained popularity over surgical tracheostomy in the intensive care setting. Percutaneous tracheostomy (PCT) requires less time to perform, it is less expensive and its typically performed sooner. In a meta-analysis of 17 randomized control trials, PDT offers several advantages such as decreased wound infections, decreased bleeding and mortality compared to surgical technique. Indications for PCT are the same as those for standard open tracheostomy. Established contraindications against PCT are unstable fractures of cervical spine, severe local infection of anterior neck and uncontrolled coagulopathy. Relative contraindications are high PEEP or oxygen requirements, difficult anatomy, proximity to extensive burns or surgical wounds, elevated ICP, hemodynamic instability and previous radiotherapy to the neck. In experienced hands, PDT seems to be a safe procedure. The number of relative contraindications to PDT declines with increasing operator experience. Overweight patients have a five times higher risk of perioperative complications with PDT than normal weight patients.

Item Type: Conference or Workshop Item (Lecture)
Additional Information: 5608/34822
Uncontrolled Keywords: cricothyrotomy, percutaneous tracheostomy, airway management
Subjects: R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User: Dr. Mohd Basri Mat Nor
Date Deposited: 26 Feb 2014 14:46
Last Modified: 26 Feb 2014 14:46
URI: http://irep.iium.edu.my/id/eprint/34822

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