OBJECTIVES: This study aimed to compare the efficacy and safety of percutaneous dilatational tracheostomy (PDT) with ultrasound (US) or bronchoscopic guidance for critically ill patients, notably obese patients. METHODS: This work was a retrospective study. The study included mechanically ventilated patients who underwent PDT from August 2013 to July 2015 in the Department of Critical Care Medicine of Zhongshan Hospital. The patients were classified according to the different guidance methods during tracheotomy and their body mass index in the following 4 groups: normal bronchoscopy group, normal US group, obese bronchoscopy group, and obese US group. The parameters, including operation time, number of punctures, intraoperative and postoperative complications, duration of the intensive care unit stay, hospitalization time, and mortality, were recorded and compared between groups. RESULTS: Compared with the obese bronchoscopy group, the obese US group had a significantly shorter PDT operation time (mean ± SD, 12.8 ± 4.8 versus 16.2 ± 4.4 minutes; P = .026), fewer punctures (P = .011), and a lesser amount of intraoperative hemorrhage (12.1 ± 4.6 versus 16.8 ± 4.3 mL; P = .009). There were no significant differences in these parameters between the normal US and normal bronchoscopy groups. CONCLUSIONS: Ultrasound-guided PDT significantly reduced the number of punctures and the operation time compared with bronchoscopy-guided PDT, and it decreased intraoperative hemorrhage in critically ill obese patients. Percutaneous dilatational tracheostomy with US guidance was a faster, safer, and more accurate method of airway management.
OBJECTIVES: This study aimed to compare the efficacy and safety of percutaneous dilatational tracheostomy (PDT) with ultrasound (US) or bronchoscopic guidance for critically illpatients, notably obesepatients. METHODS: This work was a retrospective study. The study included mechanically ventilated patients who underwent PDT from August 2013 to July 2015 in the Department of Critical Care Medicine of Zhongshan Hospital. The patients were classified according to the different guidance methods during tracheotomy and their body mass index in the following 4 groups: normal bronchoscopy group, normal US group, obese bronchoscopy group, and obese US group. The parameters, including operation time, number of punctures, intraoperative and postoperative complications, duration of the intensive care unit stay, hospitalization time, and mortality, were recorded and compared between groups. RESULTS: Compared with the obese bronchoscopy group, the obese US group had a significantly shorter PDT operation time (mean ± SD, 12.8 ± 4.8 versus 16.2 ± 4.4 minutes; P = .026), fewer punctures (P = .011), and a lesser amount of intraoperative hemorrhage (12.1 ± 4.6 versus 16.8 ± 4.3 mL; P = .009). There were no significant differences in these parameters between the normal US and normal bronchoscopy groups. CONCLUSIONS: Ultrasound-guided PDT significantly reduced the number of punctures and the operation time compared with bronchoscopy-guided PDT, and it decreased intraoperative hemorrhage in critically ill obesepatients. Percutaneous dilatational tracheostomy with US guidance was a faster, safer, and more accurate method of airway management.
Authors: Brett A Miles; Bradley Schiff; Ian Ganly; Thomas Ow; Erik Cohen; Eric Genden; Bruce Culliney; Bhoomi Mehrotra; Steven Savona; Richard J Wong; Missak Haigentz; Salvatore Caruana; Babak Givi; Kepal Patel; Kenneth Hu Journal: Head Neck Date: 2020-04-20 Impact factor: 3.147
Authors: Onat Bermede; Mehmet Cahit Sarıcaoğlu; Volkan Baytaş; Ali İhsan Hasde; Mustafa Bahadır İnan; Ahmet Rüçhan Akar Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2021-10-20 Impact factor: 0.332