Defining High-Risk Tracheostomy in the Intensive Care Unit

Percutaneous dilational tracheostomy (PDT) is becoming a ubiquitous bedside procedure in the intensive care unit (ICU) in patients requiring prolonged invasive mechanical ventilatory support. Complications of PDT include bleeding, airway compromise, hypoxemia, and procedural failure. There is no clear definition for which patients are considered high-risk for these complications, therefore, we set out to review existing data and define the clinical parameters of a high-risk tracheostomy in the ICU.

Keywords: Percutaneous dilational tracheostomy; Tracheostomy; Risk stratification; Procedural complications

Abbreviations: PDT: Percutaneous dilational tracheostomy; ICU: Intensive care unit; INR: International normalized ratio; APACHE: Acute physiology and chronic health evaluation; BMI: Body mass index; SOFA: Sequential organ failure assessment; OR: Odds ratio; CI: Confidence interval