A Modified Technique for Percutaneous Dilatational Tracheostomy

Abstract

Purpose: Percutaneous dilatational tracheostomy (PDT) is widely used in mechanical ventilation patients to facilitate weaning. This modified technique aims to reduce accidental intraprocedural airway loss and desaturation associated with current PDT techniques. Materials and Methods: This is a single-center, prospective cohort study of 100 patients who underwent a modified technique between September 8, 2022, and January 18, 2023. The procedure was performed at Shiraz University of medical science at the tertiary center, Namazi teaching hospital. In this method instead of withdrawing the endotracheal tube (ETT) up close to the vocal cord and subglottic area at the beginning of the procedure, which is a common theme in PDT techniques with accidental extubation risk, we kept the ETT and gradually withdraw it. Results: Of the 100 patients, the average age was 53.5 years, and 66% were males. On average, the procedure lasted 255 (67) seconds. All patients successfully underwent PDT with no life-threatening complications, accidental intraprocedural airway loss, or desaturation. Conclusions: As a result of this modified technique, PDT for airway management can be a safe and low-complication procedure without the risk of accidental intraprocedural airway loss. Moreover, omitting bronchoscopy and sonography during these procedures is cost-effective and secure.

Increasing the precision of simulated percutaneous dilatational tracheostomy—a pilot prototype device development study

“…Arguably, this is a clinically acceptable increase in procedural time associated with better accuracy and the potential to reduce procedural complications. The only clinically recorded standard deviation of procedural times for a PDT is around 67.1 s 19 thus we consider the increase of procedural time using GiFT to be clinically insignificant and does not detract from the main goal of our study which was focused on determining the accuracy and success of using the system. Not to mention that, innovations in procedural guidance offer additional benefits to patients and to healthcare systems.…”