Despite each technique has specific characteristics, all PDT are carried out during general anaesthesia using modified Seldinger technique (with the exception for TLT technique that uses a translaryngeal approach) and performed under continuous bronchoscope control. The dilatational techniques recognise essentially nine procedural steps. The first five, the positioning of the head, the airway management, the position of bronchoscope, the insertion of needle and Seldinger, are shared with all the techniques currently available, while the preparation of the skin, the pre-dilatation, dilatation and the cannula placement vary according to the technique.

At this time, percutaneous dilatational tracheostomies are largely used in ICU. PDT is easy to be performed with a faster learning curve [9]. PDT is a safe alternative to ST [10]. The percutaneous approach was also a skill in the training of intensive care physicians, whereas surgeons largely performed open tracheostomies [11]. The preference, background and training of physicians were responsible of the choice of the tracheostomy technique in critically ill patients.