A new technique for percutaneous dilatational tracheostomy (G‐Trach): preliminary experience in pigs

Abstract

SummaryTracheostomies are currently used for airway management in patients requiring long-term respiratory assistance. The dilatational percutaneous technique of forming tracheostomies is a valuable alternative to traditional surgical 'open' techniques. In this study, we tested a new dilatational percutaneous tracheostomy device using a balloon dilator with a particular innovative shape (G-Trach). At the Autonomous University of Barcelona Veterinary Institute, eight pigs (weighing 20-40 kg) were anaesthetised and underwent tracheostomy using the novel G-Trach technique. The mean (SD) procedure time was 2.63 (0.64) min from tracheal puncture to ventilation through the tracheostomy tube, and the mean (SD) time from positioning the dilator balloon to introducing the cannula was 0.71 (0.38) min. Vital functions and oxygen saturation remained constant throughout the procedures. Postmortem examinations did not reveal any tracheal injury. The G-Trach seems to be a safe and easy new dilatational percutaneous technique for forming tracheostomies. The minimal subcutaneous tissue dissection could potentially decrease complications when compared with standard dilatational percutaneous tracheostomy methods. To confirm this hypothesis a human trial is ongoing.

Pulmonary effects of expiratory‐assisted small‐lumen ventilation during upper airway obstruction in pigs

“…In this study, needle tracheotomy was not performed using a percutaneous technique, but following surgical exposure of the trachea. Percutaneous tracheotomy is more difficult in pigs than in humans, owing to a greater skin‐trachea distance and tracheal collapsibility . This approach was chosen to exclude malposition or kinking of the cannula as a cause of experimental failure.…”