Percutaneous Dilational Tracheostomy as a Management of Upper Airway Obstruction

Abstract

Upper airway obstruction is a condition where the airway is blocked from the nose to the larynx and upper trachea. Airway obstruction can be partial or complete. Acute upper airway obstruction is an indication for airway clearance with a tracheostomy. Tracheostomy is an act of making a hole in the anterior tracheal wall as an alternative airway. Tracheostomy has various risks such as bleeding, pneumothorax, subcutaneous emphysema, and esophageal trauma. In addition to surgical techniques, in 1985 a technique called percutaneous dilatational tracheostomy (PDT) began to develop as an alternative to tracheostomy. Percutaneous dilatational tracheostomy is a tracheostomy using minimal incisions and can be performed on bedridden patients in the Intensive Care Unit (ICU). Percutaneous dilatational tracheostomy is considered to have various advantages over surgical tracheostomy. One of the advantages is lower complications, less risk of infection, faster procedure, less bleeding, and the patient does not need to be transferred to the operating room because this procedure can be done in the ICU room. In addition, the risk of infection and bleeding in this procedure is also considered to be smaller compared to an operative tracheostomy.