Improvement of the Dilatational Tracheostomy Technique

Objective: To describe an improved technique for dilatational tracheostomy. Clinical case: We report a case of severe community-acquired polysegmental viral pneumonia, grade 2 respiratory failure. After the start antiviral therapy and staged support, female patient was placed on mechanical ventilation 12 hours following hospital admission due to increasing systemic inflammatory response cytokine storm. In 20 hours, tracheostomy using modified performed. Advantages are low trauma, short duration (5-10 minutes), significantly rarer wound infection (important benefit COVID-19 features), postoperative scarring cicatricial stenosis trachea. Technical improvement allows optimal management critically ill patients (multiple organ failure, sepsis, considerable total body surface area burns with concomitant inhalation injury), which will increase treatment efficiency, reduce number complications, speed up discharge.