Sandra Petiot1, Pierre-Grégoire Guinot2, Momar Diouf3, Elie Zogheib1, Hervé Dupont1. 1. Department of anaesthesiology and critical care medicine, Amiens university hospital, place Victor-Pauchet, 80054 Amiens, France. 2. Department of anaesthesiology and critical care medicine, Amiens university hospital, place Victor-Pauchet, 80054 Amiens, France. Electronic address: guinotpierregregoire@gmail.com. 3. Centre de recherche clinique, CHU d'Amiens, 80054 Amiens, France.
Abstract
OBJECTIVES: The objective of this study was to demonstrate and quantify the ultrasound-guided percutaneous tracheostomy (UPDT) learning curve in a single team since the first UPDT. STUDY DESIGN AND PATIENTS: This was a cohort of all consecutive patients undergoing UPDT in the Amiens teaching hospital surgical intensive care unit between 2010 and 2014. METHODS: The learning process was evaluated according to three aspects: duration of the various steps involved in UPDT, incidence of consecutive complications, and procedure difficulty. RESULTS: During the study period, 85 consecutive patients underwent UPDT with no deaths. The mean total procedure time was 22 (10) minutes (range: 7 to 60). Analysis of mean cumulative UPDT procedure times showed that total UPDT time decreased to a stable duration of 25minutes after 54 procedures. Complications were observed in 24 (28%) of the 85 patients. The overall complication rate decreased to below a stable percentage of 30% after 70 procedures. The minor complication rate decreased below 25% after 64 procedures. The moderate complication rate decreased to below a stable percentage of 10% after 10 procedures. The major complication rate decreased to below a stable percentage of 5% after 20 procedures. Most complications were observed in the first 50 patients (25 [50%] versus 6 [13%], P<0.05). CONCLUSIONS: Our study demonstrated that UPDT is associated with a fairly long learning curve. At least 50 procedures are necessary to perform UPDT with an acceptable complication rate and procedure time.
OBJECTIVES: The objective of this study was to demonstrate and quantify the ultrasound-guided percutaneous tracheostomy (UPDT) learning curve in a single team since the first UPDT. STUDY DESIGN AND PATIENTS: This was a cohort of all consecutive patients undergoing UPDT in the Amiens teaching hospital surgical intensive care unit between 2010 and 2014. METHODS: The learning process was evaluated according to three aspects: duration of the various steps involved in UPDT, incidence of consecutive complications, and procedure difficulty. RESULTS: During the study period, 85 consecutive patients underwent UPDT with no deaths. The mean total procedure time was 22 (10) minutes (range: 7 to 60). Analysis of mean cumulative UPDT procedure times showed that total UPDT time decreased to a stable duration of 25minutes after 54 procedures. Complications were observed in 24 (28%) of the 85 patients. The overall complication rate decreased to below a stable percentage of 30% after 70 procedures. The minor complication rate decreased below 25% after 64 procedures. The moderate complication rate decreased to below a stable percentage of 10% after 10 procedures. The major complication rate decreased to below a stable percentage of 5% after 20 procedures. Most complications were observed in the first 50 patients (25 [50%] versus 6 [13%], P<0.05). CONCLUSIONS: Our study demonstrated that UPDT is associated with a fairly long learning curve. At least 50 procedures are necessary to perform UPDT with an acceptable complication rate and procedure time.