Impact of Neck Length on the Safety of Percutaneous and Surgical Tracheotomy: a Prospective, Randomized Study

Tabaee, Abtin; Geng, Elvin; Lin, Jilei; Kakoullis, Stylianos; McDonald, Brian R.; Rodríguez, Hector P.; Chong, David H.

doi:10.1097/01.mlg.0000175539.25182.2a

Cited by 39 publications

(36 citation statements)

References 17 publications

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“…Previous studies also found no significant differences in the procedure related complications in trainee-led PDT group (Table 6). [10,14,15,[19][20][21][22][23] Bleeding occurred in 5% to 24% of patients who underwent PDT. [7,9,16,24] This study also found a similar incidence rate of bleeding between the trainee and intensivist groups.…”

Section: Discussionmentioning

confidence: 99%

“…The procedure time was 22 minutes(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) in the trainee group and 23 minutes(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) in the intensivist group, showing no significant difference (p = 0.323) (Table 3). PDT-related complications occurred in 23 patients (17%) in the trainee group and 9 (14%) in the intensivist group (p = 0.309).…”

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confidence: 83%

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Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by Intensive Care Trainee

Lee

Chung

Park

et al. 2014

Korean J Crit Care Med

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Background: Percutaneous dilatational tracheostomy (PDT) performed by an intensivist in critically ill patients is currently popular. Many studies support the safety and feasibility of PDT. However, there is limited data on the safety and feasibility of PDT performed by intensive care trainees. Methods: To evaluate the safety and feasibility of PDT performed by intensive care trainees and to compare these with those performed by intensivists, we retrospectively analyzed the clinical characteristics and adverse events of all prospectively registered patients who underwent PDT by ICT or intensivists in intensive care units (ICUs) from August 2010 to August 2013. Results: In the study period, 203 patients underwent PDT in ICUs; 139 (68%) by trainees and 64 (32%) by intensivists. There were no statistically significant differences in clinical characteristics including demographics, laboratory findings, and parameters of mechanical ventilation between the two groups. Procedure times and outcomes of the patients were not different between the two groups. The majority of complications observed in 24 hours after PDT were bleeding; however, there was no significant difference between the two groups (trainee 10.8% vs. intensivist 9.4%, p = 0.758). There was no procedure-related death in the two groups. Conclusions: PDT performed by intensive care trainees was safe and feasible. However, further well-designed studies should be conducted to confirm our results.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 83%

Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by Intensive Care Trainee

Lee

Chung

Park

et al. 2014

Korean J Crit Care Med

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“…In 1985, Ciaglia et al (43) described percutaneous dilational tracheostomy (PDT) in which tracheostomy is accomplished via modified Seldinger technique, typically with the aid of bronchoscopy (43). A number of clinical studies and secondary data analyses have compared tracheostomy placed by these two approaches and suggest several advantages of PDT relative to surgically created tracheostomy (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). PDT may be performed at the bedside, thus avoiding the inconvenience and risk associated with transporting a critically ill patient to the operating suite, as well as the expense of using these resources (10,44,49,64).…”

Section: Technique Of Tracheostomy Placementmentioning

confidence: 99%

Tracheostomy practice in adults with acute respiratory failure

Freeman¹,

Morris²

2012

Critical Care Medicine

135

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“…Performing PDT in morbidly obese patients carries an increased, although acceptable, risk for perioperative complications [8,20]. Patients with short necks might be at no higher risk during either a PDT or ST [21]. The decision whether to perform PDT or ST should depend upon the experience of the practitioner and the possibility to identify anatomical landmarks.…”

Section: Discussionmentioning

confidence: 99%

Technical Improvements of Difficult Tracheotomy

2014

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The aim of this study was to explore the application value of technical improvements of difficult tracheotomy. Percutaneous dilatational tracheotomy kit combined with traditional surgical tracheotomy was performed on seven patients with various types of difficult tracheotomy surgery from Jan. 2011 to Mar. 2013 in our hospital. The indicators, such as difficulty degree and intraoperative peripheral oxygen saturation changes of each patient, were assessed and analyzed. The average operating time was 20 min (from the beginning of skin incision to the implantation of the tracheal tube), and the time from cutting out tracheal cartilage rings to completely implanting tracheal tube was with 2 min; the intraoperative oxygen saturation degrees were all above 92 %. There were no serious complications, such as intraoperative hemorrhea, asphyxia, cardiac arrest, or others, and no complications, such as postoperative bleeding, pneumothorax, cervical spinal cord injury, tracheal stenosis, tracheoesophageal fistula, or others, appeared. The technical improvements used in difficult tracheotomy could reduce the risk of surgery, difficulties of the surgical operation and postoperative complications and make the operation much more easy and more suitable for the clinical application.

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Impact of Neck Length on the Safety of Percutaneous and Surgical Tracheotomy: a Prospective, Randomized Study

Abstract: We failed to demonstrate a correlation between CSD and tracheotomy related complications. Patients with short necks may be at no higher risk during either a PDT or ST. Experience, awareness of complications, and a dedicated team approach are necessary for the safe performance of PDT.

Cited by 39 publications

References 17 publications

Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by Intensive Care Trainee

Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by Intensive Care Trainee

Tracheostomy practice in adults with acute respiratory failure

Technical Improvements of Difficult Tracheotomy

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