Comparative clinical trial of progressive dilatational and forceps dilatational tracheostomy

Heurn, L.W.E. van; Mastboom, W.B.J.; Scheeren, Clarissa I.E.; Brink, Peter R.; Ramsay, Graham

doi:10.1007/s001340000743

Cited by 41 publications

(39 citation statements)

References 12 publications

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“…However, some authors regard both high PEEP and severe respiratory failure as contraindications for PDT [4,7,8,9] or decrease PEEP throughout the PDT procedure [10]. What could be the rationale for such a recommendation, other than the obvious insight that the margin of safety is less the sicker the patient?…”

Section: Discussionmentioning

confidence: 99%

“…While percutaneous dilational tracheostomy (PDT) has become a frequent procedure due to its simplicity [1], low complication rate, and time and cost effectiveness when compared to surgical tracheostomy [1,2,3,4,5,6], many physicians are reluctant to perform PDT in patients with severe respiratory failure and exclude those ventilated with a high positive end-expiratory pressure (PEEP) [4,7,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Safety of percutaneous dilational tracheostomy in patients ventilated with high positive end-expiratory pressure (PEEP)

2003

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety of percutaneous dilational tracheostomy in patients ventilated with high positive end-expiratory pressure (PEEP)

2003

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“…In a study, it was specified that the multiple dilatation technique is more reliable. In another study, it was stated that the rate of mild complications is significantly higher in the multiple dilatation technique (51,52).…”

Section: Comparison Of Pt Techniquesmentioning

confidence: 96%

Percutaneous Tracheostomy in the Intensive Care

Yıldırım¹,

Güllü²,

Demirel³

2015

Eurasian J Pulmonol

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Percutaneous tracheostomy (PT) has become an oftenly used procedure in critically ill patients requiring prolonged mechanical ventilation in recent years. The ideal timing and techniques of PT have been topics of considerable debate. In this review, we address general issues regarding PT (indications, contraindications, timing, preparation, techniques, complications) and specifically review the literatures regarding the comparison of techniques.

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“…There were no deaths related to the procedure. In 2001, Van Heurn et al 16 compared the 2 methods in 127 subjects. The tracheostomies were done by or under the supervision of surgeons.…”

Section: Ciaglia Multiple Dilator Versus Griggsmentioning

confidence: 99%

“…There were no statistically significant differences in outcome comparisons. 10 Van Heurn et al 16 Ambesh et al 11 Añon et al 12 Cantais et al 17 Nates et al 18 Montcriol et al 19 Kaiser et al 20 Cianchi et al 7 Johnson et al 21 Byhahn et al 22 Yurtseven et al 23 Kumar et al 13 Karvandian …”

Section: Ciaglia Multiple Dilator Versus Griggsmentioning

confidence: 99%

Which Percutaneous Tracheostomy Method Is Better? A Systematic Review

Sanábria

2014

Respir Care

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BACKGROUND: The aim of this study was to assess the different methods of percutaneous tracheostomy in terms of successful performance of the tracheostomy as well as safety. Tracheostomy is the most common procedure performed on the airway for patients in ICUs. Lately, several methods of percutaneous tracheostomy (multiple dilator, progressive dilator, forceps dilation, screwlike dilation, balloon dilation, and translaryngeal) have been described, with theoretical advantages, but there is no consensus about which is better. METHODS: A systematic review with critical appraisal of the literature was done. Literature in multiple databases was searched. Randomized controlled trials comparing different tracheostomy methods were selected. Clinical and methodological characteristics were assessed. A meta-analysis using fixed effect models was planned for statistically homogeneous outcomes. RESULTS: Fourteen randomized controlled trials were included, most of them with small sample sizes and with comparisons of multiple methods. Blue Rhino methods were less difficult for surgeons (risk difference of 14.7% [95% CI 8 -21.5]) and had more minor bleeding events (risk difference of ؊6.3% [95% CI ؊13.58 to 0.8]). There were no differences in major bleeding events. Statistically, heterogeneity and lack of data impede comparison with other outcomes. CONCLUSIONS: The Blue Rhino method is less difficult and has more minor bleeding events, but physicians also have more experience with this technique. However, trials are underpowered to define the best method.

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Comparative clinical trial of progressive dilatational and forceps dilatational tracheostomy

Abstract: Both percutaneous tracheostomy techniques are safe. The early complication rate of PDT appeared to be lower than FDT, but the early complication rate of FDT may be decreased significantly with small modifications to the set.

Cited by 41 publications

References 12 publications

Safety of percutaneous dilational tracheostomy in patients ventilated with high positive end-expiratory pressure (PEEP)

Safety of percutaneous dilational tracheostomy in patients ventilated with high positive end-expiratory pressure (PEEP)

Percutaneous Tracheostomy in the Intensive Care

Which Percutaneous Tracheostomy Method Is Better? A Systematic Review

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