Balloon-facilitated percutaneous dilational tracheostomy tube placement: Preliminary report of a novel technique

Objective: To describe a novel technique for percutaneous tracheotomy (PT) that could be an alternative to current dilational techniques. Design: An observational animal study of PT was performed using the Seldinger guide wire technique with a tracheostomy tube preloaded onto a dilational balloon catheter. A small skin incision was done with an 11-blade scalpel, but no blunt subcutaneous tissue dissection was performed. Setting: Animal laboratory in a university hospital. Subjects: Seven adult pigs (approximate weight, 16 to 21 kg). Measurements and results: Successful tracheostomy was accomplished in all seven pigs without apparent complication. Vital signs and oximetry results remained unchanged throughout the procedure. The mean duration of the procedure was 5.5 min from tracheal puncture to ventilation. Conclusion: This novel procedure is a simple and effective means of PT tube placement without subcutaneous tissue dissection and could potentially have decreased complications when compared to the standard methods of PT currently employed in humans. Human studies are pending.