Fiberoptic bronchoscopy–assisted percutaneous tracheostomy is safe in obese critically ill patients: A prospective and comparative study

Romero, Carlos; Cornejo, Rodrigo; Ruiz, Mauricio; Gálvez, L. Ricardo; Llanos, Osvaldo; Tobar, Eduardo; Larrondo, Jorge; Castro, Jéssica

doi:10.1016/j.jcrc.2008.06.001

Cited by 50 publications

(52 citation statements)

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“…A number of small retrospective studies documented no difference in complication rates with the PDT procedure in obese patients. [84][85][86][87][88] The largest study examining this issue reported a singlecenter prospective analysis of 1,000 PDT procedures (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)) in ICU subjects with increased bleeding risk or obesity. 89 They identified that increased international normalized ratio was the most important risk factor for bleeding (OR 2.99, 95% CI 1.26 -7.08), followed by thrombocytopenia with platelet count Ͻ 100,000 cells/L (OR 1.99, 95% CI 0.99 -3.95).…”

Section: High-risk Patients and Percutaneous Dilatational Tracheostomymentioning

confidence: 99%

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

2014

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Section: High-risk Patients and Percutaneous Dilatational Tracheostomymentioning

confidence: 99%

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

2014

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“…One study described using Doppler ultrasound over the trachea to determine the correct position of the orotracheal tube. 13 Laryngeal mask airways have been used successfully instead of oro-tracheal tubes during PCT, 7,13,16 although the relative safety of this technique is debatable. In our study we solely used US guidance to identify the tracheal cuff and pull it up enough to facilitate a tracheal puncture.…”

mentioning

confidence: 99%

“…Two other studies reported a rate of tracheal tube cuff puncture of 13%e17% for bronchoscopy-guided PCT. 7,8,16 Even though US cannot correctly identify the tracheal tube. Our goals were to evaluate the efficacy of USPCT and to describe the implementation difficulty and occurrence of complications in a critically ill population rather than demonstrate its superiority of BPPCT.…”

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confidence: 99%

Real time ultrasound-guided percutaneous tracheostomy: Is it a better option than bronchoscopic guided percutaneous tracheostomy?

Ravi

Vijay

2015

Medical Journal Armed Forces India

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Ultrasound Bronchoscopic a b s t r a c tBackground: The purpose of this study was to evaluate the efficacy of ultrasound guided percutaneous tracheostomy (USPCT) and bronchoscopic guided percutaneous tracheostomy (BPCT) and the incidence of complications in critically ill, obese patients. Methods: Seventy four consecutive patients were included in a prospective study and randomly divided into USPCT and BPCT. Incidence of complications, ease and efficacy were compared in obese USPCT (n ¼ 38)and BPCT (n ¼ 36). Results are expressed as the median (25the75th percentile) or number (percentage). Results: The median times for tracheostomy were 12 min (9e14) in USPCT patients and 18 min (12e21.5) in BPCT (p ¼ 0.05). The overall complication rate was higher in BPCT than USPCT patient group (75% vs. 321%, p < 0.05). Most complications were minor (hypotension, desaturation, tracheal cuff puncture and minor bleeding) and of higher number in the BPCT. Ultrasound-guided PCT was possible in all enrolled patients and there were no surgical conversions or deaths. Conclusions: This study demonstrated that real US-guided PCT is a favourable alternative to BPCT with a low complication rate and ease, thus proving more efficacious. A US examination provides information on cervical anatomy, vasculature etc. and hence modifies and guides choice of the PCT puncture site.

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“…As initially stated, optic fiber bronchoscope can be used to identify the endotracheal structures; however, in this method it was not required to use optic fiber bronchoscope. It had more ease and less time to do with no side effects (6)(7)(8). Unwanted puncture of the bottom of endotracheal tube is also avoided and the possibility of wrong entrance of guide needle is reduced (1,6,9).…”

Section: Discussionmentioning

confidence: 99%

Airway Management during MS-PDT Using I-GEL: A Case Report

et al. 2016

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Introduction: Percutaneous Dilated Tracheostomy by Minimally Invasive Surgery has been used as a bedside method. It can be helpful to replace ETT with a supra glotic airway device like, LMA or Igel to perform this technique appropriately. Such work has been done with LMA in previous studies. This is the first report on the use of Igel to keep the airway during MS-PDT. Case Presentation: The patient was a 36-year-old man who was diagnosed with HIV/AIDS. He was admitted due to symptoms of shortness of breath and its progress in form of respiratory distress. According to the prolonged duration of treatment and prevention of long-term complications of intubation, a tracheostomy was planned as an elective by using the Minimally Invasive Surgery-PDT method. The airway management during MS-PDT was performed by I GEL as a supraglotic airway device. Conclusion: This study was very keen on working with Igel as a useful insertion tool compared with LMA. This report would be the beginning of future works in PDT by Igel.

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Fiberoptic bronchoscopy–assisted percutaneous tracheostomy is safe in obese critically ill patients: A prospective and comparative study

Cited by 50 publications

References 49 publications

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

Real time ultrasound-guided percutaneous tracheostomy: Is it a better option than bronchoscopic guided percutaneous tracheostomy?

Airway Management during MS-PDT Using I-GEL: A Case Report

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