Impact of bedside percutaneous dilational and open surgical tracheostomy on intracranial pressure, pulmonary gas exchange, and hemodynamics in neurocritical care patients

Aim was to compare the impact of bedside percutaneous dilational tracheostomy (PDT) and open surgical technique (ST) on intracranial pressure (ICP), pulmonary gas exchange and hemodynamics. We retrospectively analyzed data of 92 neurocritical care patients with invasive ICP monitoring during either PDT (43 patients) or ST (49 patients). Peak ICP levels were higher during PDT (22 [17-38] mm Hg vs 19 [13-27] mm Hg, P=.029). Mean oxygen saturation (SpO(2)) and end-tidal carbon dioxide partial pressure (etCO(2)) did not differ. Episodes with relevant desaturation (SpO(2)50mm Hg) occurred rarely (5/49 during ST vs 3/43 during PDT for SpO(2)