Endoscopic Percutaneous Dilatational Tracheotomy: A Prospective Evaluation of 500 Consecutive Cases

Kost, Karen

doi:10.1097/01.mlg.0000163744.89688.e8

Cited by 195 publications

(214 citation statements)

References 169 publications

(248 reference statements)

Supporting

Mentioning

192

Contrasting

Unclassified

Order By: Relevance

“…Of all tracheotomies, 72.9% were performed in the first 3 weeks after endotracheal intubation (Table II). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] The period of cannulation varied strongly (range, 1-730 days) (n ¼ 291). In 146 patients (49.5%), the cannula remained in situ for a time period between 1 week and 1 month (20.3% 1-7 days and 25.3% 30-90 days).…”

Section: Clinical Time Intervalsmentioning

confidence: 99%

Complications of midline‐open tracheotomy in adults

et al. 2009

View full text Add to dashboard Cite

Objectives/Hypothesis: Percutaneous tracheotomy is progressively replacing open tracheotomy as a consequence of promising results of comparative studies. However, this comparison has four considerable weaknesses: 1) selected indications (high-risk patients excluded for percutaneous tracheotomy); 2) varying spectra of complications included in different studies; 3) varying operative settings (experienced surgeons exclusively, surgeons in training, or both); and 4) missing differentiation between different surgical techniques. Our study was performed to collect complete datasets of unselected patients who all underwent a tracheotomy in a uniform technique in an academic teaching hospital setting.Methods: Retrospective evaluation of all complications following 303 consecutive surgical tracheotomies (midline-open technique) performed by different surgeons and surgeons in training at one academic institution. Complications were classified and compared to results in the literature.Results: Rates of 21.5% minor and 1.0% major complications and 0% tracheotomy-related mortality were registered. The most prevalent complications were local wound infections (10.9%), intra-and postoperative hemorrhages (4.2%), and cartilage damage (1.7%). No significant difference was found for highrisk patients and emergency tracheotomies.Conclusions: Our study demonstrates that open tracheotomy is a safe procedure, particularly if performed in high-risk patients even by inexperienced surgeons. Therefore, we emphasize the advantages of the midline-open tracheotomy in an academic teaching hospital setting.

show abstract

Section: Clinical Time Intervalsmentioning

confidence: 99%

Complications of midline‐open tracheotomy in adults

et al. 2009

View full text Add to dashboard Cite

show abstract

“…4,5 However, bronchoscopy does not identify the vascular structures or the thyroid gland in the neck region and thus does not prevent complications linked to local organ lesions (punctured vessels or a punctured thyroid) and in patients with acute brain injury, it can cause acute elevations in intracranial pressure. Preliminary reports suggest that sonographic delineation of anatomy prior to tracheal puncture during PT may help prevent bleeding from pre-tracheal vascular structures and placement of the tracheal tube above the first tracheal ring.…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have shown that PCT should be automatically contraindicated in these groups of patients. 5,9 Many of the patients in our series had one of these factors: obesity in 15 patients (including one patient with BMI 55.9 kg/m 2 ) and cervical spine precautions in 8 patients. Nine of the obese patients who underwent USPCT in comparison to 6 BPCT had no incidence of any complication while all the six undergoing BPCT had complications (4 tracheal cuff puncture, 3 had hypoxia while 2 had moderate bleeding).…”

mentioning

confidence: 95%

Real time ultrasound-guided percutaneous tracheostomy: Is it a better option than bronchoscopic guided percutaneous tracheostomy?

Ravi

Vijay

2015

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Ultrasound Bronchoscopic a b s t r a c tBackground: 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 ¼ 38)and BPCT (n ¼ 36). Results are expressed as the median (25the75th percentile) or number (percentage). Results: The median times for tracheostomy were 12 min (9e14) in USPCT patients and 18 min (12e21.5) in BPCT (p ¼ 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.

show abstract

“…2,3 Despite the lack of any randomized controlled trials, proponents of continuous bronchoscopy claim that it may prevent major complications 4 such as misplacement of the tracheostomy tube and posterior tracheal wall laceration. A retrospective review found no difference in PDT complications with or without bronchoscopy.…”

Section: To the Editormentioning

confidence: 99%

Are New Airway Devices for Percutaneous Dilatational Tracheostomy Really Needed?

Sangwan

2015

Respir Care

View full text Add to dashboard Cite

Endoscopic Percutaneous Dilatational Tracheotomy: A Prospective Evaluation of 500 Consecutive Cases

Cited by 195 publications

References 169 publications

Complications of midline‐open tracheotomy in adults

Complications of midline‐open tracheotomy in adults

Real time ultrasound-guided percutaneous tracheostomy: Is it a better option than bronchoscopic guided percutaneous tracheostomy?

Are New Airway Devices for Percutaneous Dilatational Tracheostomy Really Needed?

Contact Info

Product

Resources

About