Extended Indications for Percutaneous Tracheostomy

Nun, Alon Ben; Altman, Eduard; Best, Lael‐Anson

doi:10.1016/j.athoracsur.2005.02.007

Cited by 41 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One case report cannot prove that puncturing the thyroid isthmus during a percutaneous tracheostomy puncture is safe. However, Ben Nun et al [ 2 ] reported five cases of percutaneous tracheostomy performed though an enlarged thyroid isthmus without complications, and we previously reported 17 cases performed without complications [ 4 ]. We believe this is the first report to provide clear postoperative radiographic images of a percutaneous tracheostomy in which the thyroid isthmus was punctured.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with standard open tracheostomy, percutaneous tracheostomy has the benefits of a smaller incision, shorter operative time, lesser intraoperative bleeding, and reduced risk of postoperative infection [ 1 ]. However, it is more difficult to avoid injury to the thyroid gland when performing a percutaneous tracheostomy, especially in patients with an enlarged thyroid gland and those with a short neck [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Successful percutaneous tracheostomy via puncture through the thyroid isthmus

Duann

Hsieh

Chen

et al. 2014

Respirology Case Reports

View full text Add to dashboard Cite

Tracheostomy is one of the most frequently performed procedures in intensive care units. Bedside percutaneous tracheostomy has become an increasingly popular option to standard open tracheostomy. Several contraindications for percutaneous tracheostomy, including an enlarged thyroid isthmus, have been described. However, as experience with this technique has increased, most of the described contraindications appear to be relative rather than absolute, provided the procedure is performed by an experienced practitioner. Herein we present a case of an unavoidable direct puncture of the thyroid isthmus during a percutaneous tracheostomy. The procedure was performed smoothly, and no complications occurred.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Successful percutaneous tracheostomy via puncture through the thyroid isthmus

Duann

Hsieh

Chen

et al. 2014

Respirology Case Reports

View full text Add to dashboard Cite

show abstract

“…With increasing familiarity with the procedure, indications for PDT have been extended to patients with previously defined contraindications, such as unfavourable anatomy, inability to extend the neck, and coagulopathy or use of anticoagulants. [12] In the immediate periprocedural period, hemorrhage is the most common complication rarely being fatal. Reported incidence of bleeding following PDT ranges from 0.5-5%.…”

Section: Discussionmentioning

confidence: 99%

Airway bleed after percutaneous tracheostomy is not always procedure-related

Patil

Singhal

Pramesh

2009

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

Tracheotomies are the most frequent surgical procedures performed in the intensive care unit. We present a case of major hemorrhage that occurred in the intensive care unit during an elective percutaneous dilational tracheostomy in a 46-year-old female diagnosed with multiple myeloma. The patient was later taken to the operation theatre and procedure-related cause of bleeding was ruled out. It was subsequently realized that the cause of bleeding was intrapulmonary and occurred coincidently with the tracheostomy.

show abstract

“…The PTs were performed by experienced intensive care specialists with more than one year of training in the technique and more than 30 procedures performed before attending high-risk cases. ( 16 , 17 ) In all cases, the presence of a respiratory disease specialist was guaranteed for fibrobronchoscopic assistance (1T30 Broncoscope, Olympus Medical Systems Corp, Tokyo, Japan) and airway management. The standardized description of the procedure has been communicated previously and can be reviewed in detail in the electronic supplementary material section ( ).…”

Section: Methodsmentioning

confidence: 99%

Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital

Romero¹,

Cornejo²,

Tobar³

et al. 2015

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

ObjectiveTo evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation.MethodsBetween the years 2004 and 2014, 512 patients with indication of tracheostomy according to clinical criteria, were prospectively and consecutively included in our study. One-third of them were high-risk patients. Demographic variables, APACHE II score, and days on mechanical ventilation prior to percutaneous tracheostomy were recorded. The efficacy of the procedure was evaluated according to an execution success rate and based on the necessity of switching to an open surgical technique. Safety was evaluated according to post-operative and operative complication rates.ResultsThe mean age of the group was 64 ± 18 years (203 women and 309 males). The mean APACHE II score was 21 ± 3. Patients remained an average of 11 ± 3 days on mechanical ventilation before percutaneous tracheostomy was performed. All procedures were successfully completed without the need to switch to an open surgical technique. Eighteen patients (3.5%) presented procedure complications. Five patients experienced transient desaturation, 4 presented low blood pressure related to sedation, and 9 presented minor bleeding, but none required a transfusion. No serious complications or deaths associated with the procedure were recorded. Eleven patients (2.1%) presented post-operative complications. Seven presented minor and transitory bleeding of the percutaneous tracheostomy stoma, 2 suffered displacement of the tracheostomy cannula, and 2 developed a superficial infection of the stoma.ConclusionPercutaneous tracheostomy using the single-step dilation technique with fiber optic bronchoscopy assistance seems to be effective and safe in critically ill patients under mechanical ventilation when performed by experienced intensive care specialists using a standardized procedure.

show abstract

Extended Indications for Percutaneous Tracheostomy

Cited by 41 publications

References 22 publications

Successful percutaneous tracheostomy via puncture through the thyroid isthmus

Successful percutaneous tracheostomy via puncture through the thyroid isthmus

Airway bleed after percutaneous tracheostomy is not always procedure-related

Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital

Contact Info

Product

Resources

About