Percutaneous vs operative tracheostomy

 Q: Which of the following has a higher risk of posterior tracheal wall perforation? (select one) 

A) Percutaneous tracheostomy 

 B) Operative tracheostomy 

Answer: A

Over the last few years, percutaneous tracheostomy has become a norm for ICU patients due to its various advantages such as its cost-effectiveness, can be performed promptly at patients' bedside, and doesn't require scheduled time in the operating room (OR). Also, it can be performed by intensivists with appropriate training. 

Said that percutaneous tracheostomy has a higher rate of anterior as well as posterior tracheal wall perforations.

#procedures

References:

1. Trottier SJ, Hazard PB, Sakabu SA, et al. Posterior tracheal wall perforation during percutaneous dilational tracheostomy: an investigation into its mechanism and prevention. Chest 1999; 115:1383. 

2.  Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care 2006; 10:R55. 

3. Silvester W, Goldsmith D, Uchino S, et al. Percutaneous versus surgical tracheostomy: A randomized controlled study with long-term follow-up. Crit Care Med 2006; 34:2145.