Chawla’s modified Griggs percutaneous tracheostomy: A safe, cost-effective alternative for resource-limited intensive care units

Objective: Percutaneous tracheostomy (PCT) offers advantages over surgical tracheostomy but remains underutilized in resource-limited settings due to dependence on bronchoscopy and costly commercial kits. Therefore, we conducted a retrospective study to evaluate the role of Chawla’s modified Griggs PCT to overcome these barriers by eliminating bronchoscopy while maintaining safety. Methods: This retrospective study analyzed 72 intensive care unit patients undergoing modified PCT (2021–2023) using sterilized reusable instruments and low-cost disposables. Outcomes included success rates, complications, procedure time, and cost savings versus commercial kits. Results: The technique achieved 100% success with a mean procedure time of 6.2 ± 2.1 min. Only 3 cases (4.2%) had minor bleeding, with no major complications. Notably effective in 46 traumatic brain injury patients (63.9%), it reduced costs by 75%–85%. No delayed complications emerged at the 6–8 week follow-up. Conclusion: This modification demonstrates PCT can be performed safely and cost-effectively without bronchoscopy in resource-limited settings. The substantial cost savings and good outcomes in high-risk patients suggest strong potential for wider adoption in low- and middle-income countries, though prospective multicenter validation is needed.