Percutaneous tracheostomy in patients with ARDS on HFOV

S Shah, M Read and P Morgan

Intensive Care, University Hospital of Wales, Cardiff, CF4 4XW, UK

from 21st International Symposium on Intensive Care and Emergency Medicine
Brussels, Belgium. 20–23 March 2001

Critical Care 2001, 5(Suppl 1):P008doi:10.1186/cc1078

Received:	15 January 2001
Published:	2 March 2001

Introduction

High Frequency Oscillator Ventilation (HFOV) is a novel lung protective strategy in the treatment of patient with acute respiratory distress syndrome (ARDS). Percutaneous tracheostomy (PCT) has become the preferred mode of achieving long-term airway in ventilated patients, to facilitate weaning and airway toileting.

Aim

To demonstrate the safety and practicability of performing a percutaneous tracheostomy on patients with ARDS whilst on a high frequency oscillator ventilator (HFOV).

Method

Percutaneous tracheostomy was performed using either Ciaglia serial dilatation or Ciaglia 'Blue Rhino' (CBR) techniques, once there was an improvement in gas exchange.

Results

See Table.

Table 1.

Discussion

In our group of five patients we performed a percutaneous tracheostomy once we were sure that their lung injury was improving i.e. improved P/F ratio, with a decreasing mean airway pressure to achieve it. There was no worsening of gas exchange perioperatively, nor was there complication associated with the percutaneous tracheostomy.

Conclusion

It is safe to perform a PCT in patient with resolving ARDS on HFOV.

References

Colan AA, Kopec SE: Tracheostomy in ICU. A review.
J Intensive Care Med 2000, 15:1-13. Publisher Full Text

This article is part of the supplement: 21st International Symposium on Intensive Care and Emergency Medicine