Tracheostomy is one of the most frequently performed techniques in intensive care units. For some authors endoscopic guide as part of the percutaneous tracheostomy (PT) might reduces the incidence of serious complications. However, for others, endoscopic guide increases the procedure cost, increases airway pressure and PaCO2 and sometimes requires the presence of another physician. International guidelines conclude that there is insufficient evidence to support the routine use of bronchoscopy during PT in order to decrease the number of complications. In addition the routine use of endoscopic guide is heterogeneous according the results of six published nation surveys. Extensive randomized trials to compare PT with endoscopic guide and without endoscopic guide are needed in order to clarify this controversial issue. This constitutes the justification of this trial. Hypothesis: Percutaneous tracheotomy performed under endoscopic guide decreases the incidence of perioperative complications of the procedure.
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Number of patients with bleeding
Timeframe: From date of randomization until 24 hours later
Number of patients with hypoxemia
Timeframe: From date of randomization until 24 hours later
Number of patients in whom a loss of airway has ocurred
Timeframe: From randomization until the end of the procedure
Number of patients with atelectasis
Timeframe: From date of randomization until 24 hours later
Number of patients with hypotension
Timeframe: From randomization until the end of the procedure
Number of patients with barotrauma
Timeframe: From date of randomization until 24 hours later
Number of patients with posterior tracheal wall injury
Timeframe: From date of randomization until 24 hours later
Number of patients in whom false passage has ocurred
Timeframe: From randomization until the end of the procedure
Number of patients in whom cardiac arrest or death directly related to any complication arising from the technique occurred
Timeframe: From date of randomization until the ICU discharge