Topics In Pulmonary MedicinePercutaneous Dilational TracheostomydeBoisblanc, Bennett P. MD; Deblieux, Peter MDAuthor Information From the Section of Pulmonary/Critical Care Medicine, LSU School of Medicine, New Orleans, LA, USA. Address correspondence to: Bennett P. deBoisblanc, MD, Professor of Medicine & Physiology, Section of Pulmonary/Critical Care Medicine, LSU School of Medicine, 1901 Perdido Strret, Suite 3205, New Orleans, LA 70112. Address e-mail to: email@example.com Clinical Pulmonary Medicine: March 2002 - Volume 9 - Issue 2 - p 109-112 Buy Abstract The technique of percutaneous dilational tracheostomy (PDT) is being increasingly used in the intensive care unit as the preferred method of placing tracheostomy tubes in patients requiring prolonged mechanical ventilation. The most commonly practiced PDT procedure utilizes the Seldinger technique for the passage of graduated, flexible, plastic dilators in the creation of a tracheostoma. A newer technique that utilizes a single tapered dilator offers significant advantages over the stepped dilator approach. The routine use of video bronchoscopy can aid in the proper positioning of the existing endotracheal tube, in the correct placement of the needle-guidewire apparatus, and in the avoidance of posterior tracheal wall pressure. In experienced hands, PDT performed at the bedside in the intensive care unit has an intraprocedural complication rate equivalent to open tracheostomy performed in the operating room with a lower rate of postprocedural complications, such as infection. Competency to perform PDT requires additional skills and training accrued through specialized courses and preceptorship. © 2002 Lippincott Williams & Wilkins, Inc.