A Prospective, Randomized Study to Compare Open Surgical Tracheostomy and Modi?ed Griggs Percutaneous Tracheostomy in Patients of Traumatic Brain Injury

Percutaneous Tracheostomy in Patients of Traumatic Brain Injury

Abstract

Background : Traumatic brain injury (TBI) patients with poor GCS usually require airway protection. Tracheostomy provides many benefits as compared to endotracheal tube. Percutaneous tracheostomy (PCT) performed by a trained professional dedicated to neurosurgical ICU may have advantages over open surgical tracheostomy. We conducted a prospective randomised study to compare both these procedures in patients of TBI. The aim is to compare open surgical tracheostomy (ST) and modified Griggs percutaneous tracheostomy (PCT) in patients of traumatic brain injury. Subjects and Methods: TBI patients in neurosurgical ICU were randomly allotted one of the two methods of tracheostomy that were being compared. Demographic profile of patients was recorded. Total duration of the procedure, length of incision, number of sutures used, days taken in wound healing after decannulation and complications were studied. Chi square and students t-test were applied for statistical analysis. Results: Demographic profile of both groups was comparable. Total duration of the procedure, length of incision, number of sutures used and days taken to heal after decannulation were significantly lesser in PCT group as compared to ST group. Overall rate of complicated procedures was similar in PCT group as compared to ST group. There was no incident of raised intracranial pressure requiring treatment. Complications were mostly minor in nature and there was no mortality reported in any group. Conclusion: Both PCT and ST have lesser rate of major complications. PCT will be beneficial for TBI patients when it is performed by a trained intensivist.