Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Crit Care. 2002 Dec;6(6):531-5. Epub 2002 Sep 17.

Cricothyroidotomy for elective airway management in critically ill trauma patients with technically challenging neck anatomy.

Author information

  • 1Oregon Health & Science University, Portland, Oregon, USA. rehmc@ohsu.edu

Abstract

INTRODUCTION:

To assess the value of elective cricothyroidotomy for airway management in critically ill trauma patients with technically challenging neck anatomy.

MATERIALS AND METHODS:

A retrospective chart review of patients admitted to the Trauma Service at a Level I Trauma Center who underwent cricothyroidotomy for elective airway management over a 40-month period from January 1997 to April 2000. Comparison was made with a cohort of Trauma Service patients who received a tracheostomy.

RESULTS:

Eighteen patients met study criteria, and an unpaired t test revealed significance (P < 0.05) for age only. There was no difference with Injury Severity Score, number of days in the intensive care unit, number of days requiring ventilation post procedure or number of days intubated prior to procedure. The major difference was the more technically challenging neck anatomy in the patients undergoing cricothyroidotomy. Five out of 18 patients undergoing cricothyroidotomy died prior to discharge and two out of 18 died after discharge from complications unrelated to their airway. Two out of 18 patients undergoing tracheostomy died prior to discharge from complications unrelated to their airway. For a period of 1 week-15 months (average, 5.5 months), notes in subsequent clinic appointments were reviewed for subjective assessment of wound healing, breathing and swallowing difficulties, and voice changes. One patient with a cricothyroidotomy required silver nitrate to treat some granulation tissue. Otherwise, no complications were identified. Telephone interviews were conducted with eight of the 11 surviving cricothyroidotomy patients and nine of the 16 surviving tracheostomy patients. One tracheostomy patient required surgical closure 3 months after discharge; otherwise, the only noted change was minor voice changes in three patients in each group. All six of these patients denied that this compromised them in any way.

CONCLUSION:

Elective cricothyroidotomy has a low complication rate and is a reasonable, technically less demanding option in critically ill patients with challenging neck anatomy requiring a surgical airway.

PMID:
12493076
[PubMed - indexed for MEDLINE]
PMCID:
PMC153438
Free PMC Article

Images from this publication.See all images (2)Free text

Figure 1
Figure 2
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for BioMed Central Icon for PubMed Central
    Loading ...
    Write to the Help Desk