Comparison of Bronchoscopy-Guided and Real-Time Ultrasound-Guided Percutaneous Dilatational Tracheostomy: Safety, Complications, and Effectiveness in Critically Ill Patients

Abstract

Ultrasound-guided percutaneous dilatational tracheostomy is a safe procedure for critically ill patients and has the advantages of a low complication rate, short duration of procedure, being informative with regard to neck anatomy, and facilitating prevention of vascular puncture. Thus, US-PDT can be used as an alternative to FOB-PDT.

Ultrasound‐Guided Percutaneous Dilatational Tracheostomies in 2 Difficult Airways

“…12 Ultrasound has proved to diminish the duration of the procedure, as well as the hemorrhage associated with it. 7 It has also been observed that episodes of oxygen desaturation (<90%) are less frequent when this technique is used. 13 Because of this advantage, US imaging has been suggested as the first-line technique for percutaneous dilatational tracheostomies in patients with neck anatomic abnormalities.…”

“…In a previous trial, a US‐guided percutaneous dilatational tracheostomy proved not to be inferior to a bronchoscopy‐guided percutaneous dilatational tracheostomy . Ultrasound has proved to diminish the duration of the procedure, as well as the hemorrhage associated with it . It has also been observed that episodes of oxygen desaturation (<90%) are less frequent when this technique is used .…”

“…5 Tracheal US has already been described, although, unlike our cases, it was mostly used in patients without any anatomic abnormalities. 6,7 The trachea is composed of cartilaginous rings, which are covered by skin, fat, strap muscles, and thyroid tissue. One must learn to identify these structures when scanning.…”

The Efficacy of Ultrasound to Evaluate The Neck Structures Before Tracheostomy and To Determine The Methods of Tracheostomy: Percutaneous or Surgical?

“…US has several advantages, such as high portability, safety, and reliability; furthermore, it is a pain free, simple procedure (10,11). Many studies have stated that the use of PDT with real time US is a reliable and effective method that reduces complications (12,13).…”

Comparing Percutaneous Dilatational Tracheostomy With Bronchoscopic and Ultrasound Guidance

“…7 Thus, when assessing the safety of PDT with US and bronchoscopic guidance in critically ill patients, in addition to complications, the study design should also include intergroup comparisons with respect to the quality of ventilation, analysis of blood gases, and the PaO 2 -to-FIO 2 ratio, as performed in previous studies. [5][6][7][8] Chao Wen, MD, Fu-Shan Xue, MD , Jin-Hua Jin, MD, Qing Liu, MD…”