Percutaneous dilatational tracheostomy: Griggs guide wire dilating forceps technique versus ULTRA-perc single-stage dilator - A prospective randomized study

Percutaneous dilatational tracheostomy (PDT) is a frequently performed surgical procedure on critically ill patients. This study was designed to compare its two methods: Griggs guide wire dilating forceps (GWDF) technique and the ULTRA-perc single-stage dilator technique. Materials and Methods: Thirty Intensive Care Unit (ICU) patients on prolonged mechanical ventilation and requiring tracheostomy were included in our prospective randomized study. The first group (GP-GWDF) underwent PDT by the GWDF technique and the second group by the ULTRA-perc technique (GP-UP). Time for the procedure and early and late procedural complications were recorded and compared in between the two groups. Results: Time taken for tracheostomy was 11.68 6.48 min for GP-GWDF and 13.93 11.54 min for GP-UP (P-value 0.486). Desaturation was noted in two patients in GP-GWDF versus five in GP-UP (P-value = 0.195). Hypercapnea and rise in peak airway pressure occurred in one patient in GP-GWDF versus two in GP-UP (P-value = 0.543). Loss of airway was recorded in two patients in GP-UP and in none in GP-GWDF (P-value = 0.143). Subcutaneous emphysema, pneumothorax and pneumomediastinum occurred in one patient in GP-UP. No major complications were observed in GP-GWDF (P-value = 0.309). Hoarseness of voice was noted in one patient in each group (P-value = 0.659). Conclusion: Both the techniques seem to be equally reliable for carrying out PDT at bedside in the ICU.