2017
DOI: 10.1002/jum.14448
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Comparison of Percutaneous Dilatational Tracheostomy Guided by Ultrasound and Bronchoscopy in Critically Ill Obese Patients

Abstract: Ultrasound-guided PDT significantly reduced the number of punctures and the operation time compared with bronchoscopy-guided PDT, and it decreased intraoperative hemorrhage in critically ill obese patients. Percutaneous dilatational tracheostomy with US guidance was a faster, safer, and more accurate method of airway management.

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Cited by 21 publications
(30 citation statements)
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“…149 On this basis, Song et al compared the outcome of percutaneous dilational tracheostomy performed under fiberoptic or ultrasound guidance in obese, critically ill patients. 150 Despite the limited number of patients included in their study, they were not able to find any difference in the complication rate between the two approaches; indeed, the ultrasound-guided technique was associated with a reduced number of puncture attempts, a shorter duration of the procedure, and reduced intraoperative hemorrhage. In conclusion, the percutaneous dilational approach seems to be the technique of choice for performing a tracheostomy in obese, critically ill patients, provided that it is performed under fiberoptic or ultrasound guidance.…”
Section: Tracheostomymentioning
confidence: 90%
“…149 On this basis, Song et al compared the outcome of percutaneous dilational tracheostomy performed under fiberoptic or ultrasound guidance in obese, critically ill patients. 150 Despite the limited number of patients included in their study, they were not able to find any difference in the complication rate between the two approaches; indeed, the ultrasound-guided technique was associated with a reduced number of puncture attempts, a shorter duration of the procedure, and reduced intraoperative hemorrhage. In conclusion, the percutaneous dilational approach seems to be the technique of choice for performing a tracheostomy in obese, critically ill patients, provided that it is performed under fiberoptic or ultrasound guidance.…”
Section: Tracheostomymentioning
confidence: 90%
“…Therefore, if there are no anatomical or other contraindications, percutaneous dilational tracheostomy may be considered if the expertise is available. It should be remembered that the decrease in aerosolization during percutaneous tracheostomy only holds true if airway manipulation (ie, bronchoscopy with cuff deflation or concurrent ventilation) is not performed, and although there have been some associated higher complication rates with blind percutaneous tracheostomy compared to bronchoscopic technique, ultrasound‐guided techniques have been shown to be noninferior to bronchoscopic techniques 44‐46 . Therefore, when considering a percutaneous tracheostomy, a closed ultrasound‐guided or “cuff‐up” apneic technique is recommended for SARS‐CoV‐2 patients.…”
Section: Recommendationsmentioning
confidence: 99%
“…Several recent studies suggest that in experienced operators, US-guided PT compares favorably with bronchoscopic-guided PT, even in obese patients. [63][64][65] US-guided PT has the potential benefit of reducing the number of punctures and decreasing the bleeding rate. 65 US guidance of PT can also be used in conjunction with bronchoscopic guidance, to more precisely identify the selection of entry site and level of tracheal interspace.…”
Section: Ultrasound-guided Percutaneous Tracheostomymentioning
confidence: 99%