Endoscopic Guided Percutaneous Tracheostomy: Early Results of a Consecutive Trial

Marelli, Daniel; Paul, Andreas; Manolidis, S.; Walsh, Garrett L.; Odim, Jonah; Burdon, Thomas A.; Shennib, H; Vestweber, K. H.; Fleiszer, David; Mulder, David S.

doi:10.1097/00005373-199004000-00012

Cited by 221 publications

(141 citation statements)

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“…Another study of 61 ICU patients who underwent bronchoscopy guided PT reported one procedure-related death due to arrhythmia (67). There was a 50% reduction in cost with PT compared to operative tracheostomy (67).…”

Section: Pt Versus Stmentioning

confidence: 99%

Percutaneous tracheostomy: a comprehensive review

Rashid

Islam

2017

J. Thorac. Dis.

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Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world.Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population. Ultrasound can be helpful in limited cases to identify the neck structure especially in patients with a difficult anatomy. Bronchoscopy during PT can shorten the duration and avoid complications.PT has favorable complication rate, lower infection rate, shorter procedural duration and is cost-effective.Experience with the technique and careful planning is needed to minimize any avoidable potential complication.

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Section: Pt Versus Stmentioning

confidence: 99%

Percutaneous tracheostomy: a comprehensive review

Rashid

Islam

2017

J. Thorac. Dis.

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“…Fibreoptic bronchoscopy should confirm correct placement of the seeker needle, guide-wire, dilator and tracheostomy cannula within the trachea. Case series employing fibreoptic bronchoscopy report a low incidence of complications [19,20] but no comparative data or randomised, controlled studies are available. Given the low incidence of serious haemorrhage, it is unlikely that studies of sufficient power to demonstrate a difference could be undertaken.…”

Section: Discussionmentioning

confidence: 99%

Mortality from percutaneous dilatational tracheostomy. A report of three cases*

McCormick¹,

Manara

2005

Anaesthesia

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SummaryWe report three deaths following percutaneous dilatational tracheostomy in a series of 1187 procedures undertaken in a single intensive care unit over a 13‐year period. All deaths were due to severe haemorrhage. The first patient died during the procedure from uncontrollable haemorrhage from the innominate vein. Delayed haemorrhage in the other two patients was caused by the tracheostomy tube eroding into the aorta in one patient and into the innominate vein in the other. In both these patients, the tracheal stoma was found at postmortem to be sited unexpectedly low. Fatal haemorrhage is a rare complication of percutaneous tracheostomy (0.25% in this series), but is probably under‐reported. While bronchoscopy is now used routinely during percutaneous tracheostomy insertion in most units, we speculate that ultrasound examination of the neck is more likely to identify major vascular structures at risk. However, whilst intuitive, there is little evidence that either bronchoscopy or ultrasound scanning reduces the incidence of complications. Magnetic resonance images of normal subjects are presented to demonstrate the anatomical relations of the trachea to major vascular structures and their variability.

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“…Previous reports described methods to minimize the risk of a false passage during percutaneous tracheostomy and during replacement of dislodged tracheostomy tubes. These suggestions included the use of a fibreoptic bronchoscope 3 and a nasogastric tube 4 respectively. However, in the present report, we suggest a method for re-establishment of the airway and providing rescue oxygenation during tracheostomy.…”

Section: Discussionmentioning

confidence: 99%