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Petros, Sirak

doi:10.1186/cc340

Cited by 29 publications

(8 citation statements)

References 42 publications

(90 reference statements)

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“…There is a presumption that balloon dilation minimizes the pressure on the tracheal wall as compared to other techniques. [ 2 22 23 24 25 26 27 ]…”

Section: Fantoni Translaryngeal Tracheostomymentioning

confidence: 99%

Percutaneous tracheostomy

Mehta¹,

Mehta²

2017

Ann Card Anaesth

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Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists. This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in few selected cases. Most common indication of tracheostomy in ICU is need for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomised during ICU stay. The ideal timing of PDT remains undecided at present. Contraindications and complications become fewer with increase in experience. Various methods of performing PDT have been discovered in last two decades. Preoperative work up, patient selection and post tracheostomy care form key components of a successful PDT. Bronchoscopy and ultrasound have been found to be useful procedural adjuncts, especially in presence of unfavorable anatomy. This article gives a brief overview about the use of PDT in ICU.

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“…There is a presumption that balloon dilation minimizes the pressure on the tracheal wall as compared to other techniques. [ 2 22 23 24 25 26 27 ]…”

Section: Fantoni Translaryngeal Tracheostomymentioning

confidence: 99%

Percutaneous tracheostomy

Mehta¹,

Mehta²

2017

Ann Card Anaesth

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“…The main postoperative complication after PT is bleeding. 15 , 16 We observed bleeding in 39.6% of study subjects, yet in majority of cases, it was very mild and stopped without any intervention. Higher bleeding rate, compared to reports from other studies, is probably related to strict registration of any bleeding in our prospective study.…”

Section: Discussionmentioning

confidence: 74%

“…Major bleeding occurred in 3.6% of cases, a result similar to other studies. 10 , 16 There were no differences in postoperative bleeding in study subjects with different extent of surgical dissection, neither was bleeding influenced by to study subjects’ preoperative INR value. Using forceps for tracheal wall dilatation seemed to cause more postoperative bleeding, compared to the use of dilatators; however, the difference did not reach statistical significance.…”

Section: Discussionmentioning

confidence: 82%

Prospective study of percutaneous tracheostomy: Role of bronchoscopy and surgical technique

et al. 2016

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Objective:Percutaneous tracheostomy is a common procedure but varies considerably in approach. The aim of our study was to evaluate the need for intraoperative bronchoscopy and to compare various surgical techniques.Methods:During 1 year all percutaneous tracheostomies in three intensive care units were prospectively documented according to a unified protocol. In one unit, bronchoscopy was used routinely and in others only during the study.Results:A total of 111 subjects (77 males) with median age 64 (range, 18–86) years and body mass index 25.4 (range, 15.9–50.7) were included. In unit A, tracheal wall was directly exposed; in unit B, limited dissection to enable tracheal palpation was made. In both units, bronchoscopy was used to check the location of an already inserted guiding needle; needle position required correction in 8% and 12% of cases, respectively. In unit C, in tracheostomies without pretracheal tissue dissection, bronchoscopy was used to guide needle insertion; needle position required correction in 66% of cases. Median duration of operations performed by thoracic surgeons and residents was 10 (range, 3–37) min and by intensive care doctors and residents was 16.5 (range, 3–63) min (p < 0.001). Time from the beginning of preparations for tracheostomy until the end of the whole procedure was median 32 min for bedside tracheostomies and 64 min for operations in the operating theatre (p < 0.001).Conclusion:Limited pretracheal tissue dissection enabled proper guiding needle insertion and bronchoscopy was rarely needed. Percutaneous tracheostomies performed by thoracic surgeons took less time, and duration of the whole procedure was remarkably shorter when performed at bedside.

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“…Bleeding has been reported as the most common perioperative complication in most series [1]. Patients with severe liver disease frequently have a coagulopathy and thrombocytopaenia.…”

Section: Introductionmentioning

confidence: 99%