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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Comparison of ICP-monitoring values in standard and a modified Griggs' treacheostomy technique

Vergleich der Ergebnisse des ICP-Monitorings bei konventioneller und modifizierter Tracheotomie-Technik nach Griggs

Meeting Abstract

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  • corresponding author M. H. Reinges - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • F. Hans - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • M. Lancé - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • J. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum Aachen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-16.11

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0266.shtml

Published: May 4, 2005

© 2005 Reinges et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To evaluate a modified Griggs’ dilatational tracheostomy technique in neurosurgical patients, and to compare it with the standard technique of Griggs et al.

Methods

Bedside tracheostomy was performed in 46 neurosurgical patients. In 10 patients (group 1) the standard Griggs' technique was used, in 36 patients (group 2) a modified technique. In group 2 the original technique of Griggs et al. was modified as follows: The head of bed was elevated to 30°, the head was not reclined or only moderately, and, to overcome this space limitation, the skin incision was made larger (2 - 3 cm). This larger skin incision permitted dissection to the trachea and palpation of the tracheal rings. Afterwards, the original puncture-dilatational technique was completed. Intracerebral pressure (ICP), end-tidal CO2 (ETCO2), and cerebral perfusion pressure (CPP) were assessed in all patients.

Results

In group 1, a mean rise of ICP of 9 (0 – 18) mmHg above baseline values was observed, whereas in group 2, a mean rise of ICP of 5 (0 – 15) mmHg above baseline values was seen. Similarly, the rise of ETCO2 was larger in group 1 in comparison with group 2. All patients maintained CPP above 60 mmHg during the procedure.

Conclusions

With the described modifications, bedside dilatational tracheostomy can safely be performed in critically ill neurosurgical patients, who are at risk of ICP increase. It seems, that the described modifications of the original technique of Griggs et al. lead to reduced elevation of ICP during the procedure, thus, potentially reducing morbidity.