Single dilator vs. guide wire dilating forceps tracheostomy: a meta-analysis of randomised trials

Cabrini, Luca; Landoni, Giovanni; Greco, Massimiliano; Costagliola, R; Monti, Giacomo; Colombo, Stefania; Greco, Teresa; Pasin, Laura; Borghi, Giovanni; Zangrillo, Alberto

doi:10.1111/aas.12213

Cited by 20 publications

(19 citation statements)

References 38 publications

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“…However, single dilatation percutaneous technique was suggested due to low complication rate and it is demonstrated that GWDF was a faster method than CBR [16, 23, 24]. Yet, Cabrini et al showed that there was no difference between mid and long term complications of single dilatation and GWDF techniques [25]. We also found that GWDF (70.4%) was often used as EPT technique in Turkey (Table 2).…”

Section: Discussionmentioning

confidence: 61%

Elective Tracheotomy Practices in Turkey

2016

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ObjectivesElective tracheotomy (ET) procedures in intensive care units (ICU) might be different in accordance with countries and ICUs’ features. The aim of the present study was to search the epidemiology of ET procedures in Turkey.MethodsA questionnaire which consists of 43 questions was sent by e-mail to 238 ICUs which were officially recognized by The Turkish Ministry of Health. All answers were obtained between August 1, 2015 and August 31, 2015.ResultsTwo hundred and three ICUs (85.3%) participated in this study. 177 (87.2%) and 169 (83.4%) of ICU’s were level III and mixed ICUs respectively. Anesthesiologists were the director of 189 (93.0%) ICUs. Estimated total count of admitted, mechanically ventilated and tracheotomized patients in 2014 were 126282, 80569 (63.8%) and 8989 (7.1%) respectively. Most common indication for ET was prolonged mechanical ventilation (76.9%). The first choice for ET procedure was percutaneous in 162 (79.8%) ICUs. Griggs guide wire dilatational forceps (GWDF) technique was used as the first choice for elective percutaneous tracheotomy (EPT) by 143 (70.4%) ICUs. Most common early EPT complication was bleeding (68.0%) and late EPT complication was stenosis (35.0%). While facilitation of weaning was most important advantage (26.1%), bleeding and tracheal complications were most important disadvantages for EPT (29.1%).ConclusionsMost common indications for ET are prolonged MV and coma in Turkish ICUs. EPT is the preferred procedure for ET and GWDF is the most common technique. Bronchoscopy and USG are rarely used as a guide.

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Section: Discussionmentioning

confidence: 61%

Elective Tracheotomy Practices in Turkey

2016

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“…They also found that the STD was associated with fewer complications and failures. In a later analysis, the same authors reported less operative bleeding and fewer technical difficulties associated with the STD technique than those associated with the GWDF technique (6).…”

mentioning

confidence: 88%

“…Although the short-term complications of these techniques are well described, the prevalence and impact of longer-term outcomes, particularly tracheal stenosis (TS), are unclear. Previous metaanalyses have attempted to address this problem but have been confounded by the low prevalence of TS and, in particular, the limited number of studies reporting long-term outcomes (2)(3)(4)(5)(6).…”

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confidence: 99%

Long-Term Outcome Following Tracheostomy in Critical Care

Dempsey

Morton

Hammell

et al. 2016

Critical Care Medicine

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Considering comparative data, there was no significant difference in the prevalence of tracheal stenosis or major bleeding between percutaneous and surgical tracheostomy. In relation to wound infection, we have found a reduction associated with the original Ciaglia technique when compared with that with the surgical tracheostomy. Considering all published data reporting long-term outcomes pooled proportion meta-analysis indicates a trend toward a higher rate of tracheal stenosis and an increased risk of major bleeding and wound infection for surgical tracheostomies. This finding may be biased as a result of targeted patient selection, and further, high-quality long-term comparative data are needed to confirm these findings.

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“…[26][27][28][29][30] A meta-analysis of these trials found evidence of superiority of the Ciaglia technique using a combined endpoint representing procedural difficulties and bleeding. 31…”

Section: Griggs Techniquementioning

confidence: 99%

Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy

Belanger

Akulian

2014

Semin Respir Crit Care Med

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Bedside percutaneous tracheostomy and gastrostomy tube placement are cost-effective and safe techniques employed in the management of critically ill patients requiring prolonged mechanical ventilation. Both procedures have been well characterized and studied in the surgical and gastroenterology literature. Recently the performance of these procedures by interventional pulmonologists have been reported. This review focuses on the role of the interventional pulmonologist in the ICU, specifically in regard to the placement of percutaneous tracheostomies and gastrostomy tubes. We will discuss the techniques available and the relevant background data regarding choice of method and its integration into clinical practice. In addition, we discuss the creation of a multidisciplinary tracheostomy care team, its effect on patient care, hospital finances, and the interventional pulmonologists role.

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Single dilator vs. guide wire dilating forceps tracheostomy: a meta-analysis of randomised trials

Cited by 20 publications

References 38 publications

Elective Tracheotomy Practices in Turkey

Elective Tracheotomy Practices in Turkey

Long-Term Outcome Following Tracheostomy in Critical Care

Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy

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