Emergency percutaneous tracheotomy in failed intubation

Beshey, Bassem Nashaat; Helmy, Tamer A.; Asaad, Hany; Ibrahim, Emad El-Din Mostafa

doi:10.1016/j.ejcdt.2014.07.016

Cited by 9 publications

(16 citation statements)

References 33 publications

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“…In our study, the average time required was 4.17 ± 1. experience can ensure application in emergency situations. 11,20,21 There are few limitations of our study. The number of patients included in the study was small.…”

Section: Discussionmentioning

confidence: 93%

Percutaneous tracheostomy by Griggs technique: a retrospective analysis

2015

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Percutaneous tracheostomy (PCT) is emerging as a popular method to secure a definitive airway in ventilated patients in critical care units as an alternative to surgical tracheostomy. It offers several advantages such as ease of performance, small skin incision, less tissue trauma, lower infection rate, bedside conduct as well as optimum utilization of ICU personnel. 1,2 The scope of PCT is increasing with training and experience, with successful management of more and more scenarios which were earlier perceived as contra indications. The present study was taken up with the objectives to evaluate safety of PCT in patients with difficult anatomy, bleeding diathesis and high ventilatory requirement, which are described as relative contra indications. We also intended to assess the complication rate and determine average time required.

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Section: Discussionmentioning

confidence: 93%

Percutaneous tracheostomy by Griggs technique: a retrospective analysis

2015

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“…The number of studies in each category is not additive. Five studies reported only tracheostomy complications [15][16][17][18][19]; 14 studies reported only cricothyroidotomy complications [20][21][22][23][24][25][26][27][28][29][30][31][32][33]; and two studies reported complications from both techniques (RCT included) [34,35].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining articles contained only emergency procedures. In the TRACH group, three articles performed percutaneous [16,17,35], and four performed surgical approach [15,18,19,34]. In the CRICO group, only one article used percutaneous [35], one used both (13 procedures under percutaneous and 16 under surgical) [27], and all other used surgical technique [20][21][22][23][24][25][26][28][29][30][31][32][33][34] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Complications of cricothyroidotomy versus tracheostomy in emergency surgical airway management: a systematic review

et al. 2020

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Background: Airway guidelines recommend an emergency surgical airway as a potential life-saving treatment in a "Can't Intubate, Can't Oxygenate" (CICO) situation. Surgical airways can be achieved either through a cricothyroidotomy or tracheostomy. The current literature has limited data regarding complications of cricothyroidotomy and tracheostomy in an emergency situation. The objective of this systematic review is to analyze complications following cricothyroidotomy and tracheostomy in airway emergencies. Methods: This synthesis of literature was exempt from ethics approval. Eight databases were searched from inception to October 2018, using a comprehensive search strategy. Studies were included if they were randomized controlled trials or observational studies reporting complications following emergency surgical airway. Complications were classified as minor (evolving to spontaneous remission or not requiring intervention or not persisting chronically), major (requiring intervention or persisting chronically), early (from the start of the procedure up to 7 days) and late (beyond 7 days of the procedure). Results: We retrieved 2659 references from our search criteria. Following the removal of duplicates, title and abstract review, 33 articles were selected for full-text reading. Twenty-one articles were finally included in the systematic review. We found no differences in minor, major or early complications between the two techniques. However, late complications were significantly more frequent in the tracheostomy group [OR (95% CI) 0.21 (0.20-0.22), p < 0.0001]. Conclusions: Our results demonstrate that cricothyroidotomies performed in emergent situations resulted in fewer late complications than tracheostomies. This finding supports the recommendations from the latest Difficult Airway Society (DAS) guidelines regarding using cricothyroidotomy as the technique of choice for emergency surgical airway. However, emergency cricothyroidotomies should be converted to tracheostomies in a timely fashion as there is insufficient evidence to suggest that emergency cricothyrotomies are long term airways.

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Section: -Flow Chart)mentioning

confidence: 99%

Complications of cricothyroidotomy versus tracheostomy in emergency surgical airway management: A systematic review

Zasso

You-Ten

Ryu

et al. 2020

Preprint

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Background Airway guidelines recommend an emergency surgical airway as a potential life-saving treatment in a “Can’t Intubate, Can’t Oxygenate” (CICO) situation. Surgical airways can be achieved either through a cricothyroidotomy or tracheostomy. The current literature has limited data regarding complications of cricothyroidotomy and tracheostomy in an emergency situation, such as in a CICO scenario. The objective of this systematic review is to analyze complications following cricothyroidotomy and tracheostomy in this situation. Methods This synthesis of literature was exempt from ethics approval. Eight databases were searched from inception to October 2018, using a comprehensive search strategy. Studies were included if they were randomized controlled trials or observational studies reporting complications following emergency surgical airway. Complications were classified as minor (evolving to spontaneous remission or not requiring intervention or not persisting chronically), major (requiring intervention or persisting chronically), early (from the start of the procedure up to seven days) and late (beyond seven days of the procedure). Results We retrieved 2,659 references from our search criteria. Following the removal of duplicates, title and abstract review, 33 articles were selected for full-text reading. 21 articles were finally included in the systematic review. We found no differences in minor, major or early complications between the two techniques. However, late complications were significantly more frequent in the tracheostomy group [OR (95% CI) 0.21 (0.20-0.22), p<0.0001]. Conclusions Our results demonstrate that cricothyroidotomies performed in emergent situations resulted in fewer late complications than tracheostomies. This may be indicative that cricothyroidotomy is safer than tracheostomy as an emergency surgical airway. This finding supports the recommendations from the latest Difficult Airway Society (DAS) guidelines regarding using cricothyroidotomy as the technique of choice for emergency surgical airway in a CICO situation.

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Emergency percutaneous tracheotomy in failed intubation

Cited by 9 publications

References 33 publications

Percutaneous tracheostomy by Griggs technique: a retrospective analysis

Percutaneous tracheostomy by Griggs technique: a retrospective analysis

Complications of cricothyroidotomy versus tracheostomy in emergency surgical airway management: a systematic review

Complications of cricothyroidotomy versus tracheostomy in emergency surgical airway management: A systematic review

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