Parli Raghavan Ravi1, M N Vijay2. 1. Senior Advisor (Anaesthesiology), 5 Air Force Hospital, C/O 99 APO, India. 2. Classified Specialist (Anaesthesiology), Command Hospital Air Force, Bangalore, India.
Abstract
BACKGROUND: 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 = 38)and BPCT (n = 36). Results are expressed as the median (25th-75th percentile) or number (percentage). RESULTS: The median times for tracheostomy were 12 min (9-14) in USPCT patients and 18 min (12-21.5) in BPCT (p = 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.
RCT Entities:
BACKGROUND: 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, obesepatients. 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 = 38)and BPCT (n = 36). Results are expressed as the median (25th-75th percentile) or number (percentage). RESULTS: The median times for tracheostomy were 12 min (9-14) in USPCT patients and 18 min (12-21.5) in BPCT (p = 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.
Authors: Carlos M Romero; Rodrigo A Cornejo; Mauricio H Ruiz; L Ricardo Gálvez; Osvaldo P Llanos; Eduardo A Tobar; Jorge F Larrondo; José S Castro Journal: J Crit Care Date: 2008-09-11 Impact factor: 3.425
Authors: Mandeep Singh; Ki Jinn Chin; Vincent W S Chan; David T Wong; Govindarajulu A Prasad; Eugene Yu Journal: J Ultrasound Med Date: 2010-01 Impact factor: 2.153
Authors: André Luiz Nunes Gobatto; Bruno A M P Besen; Paulo F G M M Tierno; Pedro V Mendes; Filipe Cadamuro; Daniel Joelsons; Livia Melro; Maria J C Carmona; Gregorio Santori; Paolo Pelosi; Marcelo Park; Luiz M S Malbouisson Journal: Intensive Care Med Date: 2016-02-01 Impact factor: 17.440