الفهرس 
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Abstract
This study was carried out at Respiratory ICU - Chest Department, Operating Room of torhinolaryngology Department at Tanta University Hospitals and Respiratory ICU at Airforces Hospital, from August 2020 to December 2021. Aim of the work was to compare between open and percutaneous tracheostomy to improve outcomes of critically ill patients who needed tracheostomy. Thirty patients were included in this study and divided into two groups: 15 patients underwent surgical tracheostomy (ST; group I) and another 15 patients underwent percutaneous tracheostomy (PT; group II). Study design: Experimental randomized controlled study (simple randomization) All patients in this study were subjected to history taking, clinical examination, various investigation in the form of (bleeding profile, ABG, CBC, Chest X ray, and ECHO). Results: Regarding demographic data of the patients, age (years), gender, intubation period prior to tracheostomy (days) were insignificantly different between both groups, while neck circumference (cm) was significantly higher in ST group than PT group. (p value = p= 0.013) • There was an insignificant difference in comorbid conditions between ST group and PT group. • There was insignificant difference in Primary Cause on admission in ICU between ST group and PT group. • Duration of procedure was significantly increased in ST group than PT group (P<0.001). • In ST group, there was an insignificant difference in mean of percentage of change of (FiO2, O2 saturation, PaO2, PaO2/FiO2, and pH) between both groups. But, regarding mean of percentage of change of Pa co2 there was a signifigant difference between both groups. ( p=0.001 ) • Intraoperative early and intermediate complications were insignificantly different between both groups. • Delayed complications were insignificantly different between the two groups except for stomal infections which was significantly higher in the ST group. ( pFE = 0.042) • Regarding outcomes of procedure, successful decannulation, permanent tracheostomy, and death they were insignificantly different between the both groups.