Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy

Belanger, Adam R.; Akulian, Jason

doi:10.1055/s-0034-1395504

Cited by 8 publications

(5 citation statements)

References 52 publications

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“…In addition, there are pre-COVID-19 data that suggest performing tracheostomy and gastrostomy procedures using a gastroscope and/or bronchoscope in the same sitting by a single specialty has a good safety profile with possible advantages of shorter ICU and hospital length of stay. [82][83][84][85] This could be considered in institutions with such expertise, but there might be concerns for the additional time required to perform percutaneous endoscopic gastrostomy placement, leading to extended exposure time.…”

Section: Role Of Preprocedural Covid-19 Testingmentioning

confidence: 99%

Use of Tracheostomy During the COVID-19 Pandemic

Lamb

Desai

Angel

et al. 2020

Chest

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BACKGROUND: The role of tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic remains unknown. The goal of this consensus statement is to examine the current evidence for performing tracheostomy in patients with respiratory failure from COVID-19 and offer guidance to physicians on the preparation, timing, and technique while minimizing the risk of infection to health care workers (HCWs). METHODS: A panel including intensivists and interventional pulmonologists from three professional societies representing 13 institutions with experience in managing patients with COVID-19 across a spectrum of health-care environments developed key clinical questions addressing specific topics on tracheostomy in COVID-19. A systematic review of the literature and an established modified Delphi consensus methodology were applied to provide a reliable evidence-based consensus statement and expert panel report. RESULTS: Eight key questions, corresponding to 14 decision points, were rated by the panel. The results were aggregated, resulting in eight main recommendations and five additional remarks intended to guide health-care providers in the decision-making process pertinent to tracheostomy in patients with COVID-19-related respiratory failure. CONCLUSION: This panel suggests performing tracheostomy in patients expected to require prolonged mechanical ventilation. A specific timing of tracheostomy cannot be recommended. There is no evidence for routine repeat reverse transcription polymerase chain reaction testing in patients with confirmed COVID-19 evaluated for tracheostomy. To reduce the risk of infection in HCWs, we recommend performing the procedure using techniques that minimize aerosolization while wearing enhanced personal protective equipment. The recommendations presented in this statement may change as more experience is gained during this pandemic.

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Section: Role Of Preprocedural Covid-19 Testingmentioning

confidence: 99%

Use of Tracheostomy During the COVID-19 Pandemic

Lamb

Desai

Angel

et al. 2020

Chest

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“…PEG tube placement has been described in patients with Crohn's disease, cystic fibrosis, severe trauma, and altered level of consciousness (61).…”

Section: Miscellaneousmentioning

confidence: 99%

“…A skin disc is secured over the feeding tube to keep it in place (61,62). The per-oral pull and per-oral push techniques, however, may not be possible or may be contraindicated in a variety of clinical scenarios.…”

Section: Per-oral Push Techniquementioning

confidence: 99%

An overview of percutaneous endoscopic gastrostomy tube placement in the intensive care unit

Wei¹,

Ho²,

Hegde³

2021

J Thorac Dis

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Critically ill patients are at increased risk for malnutrition as they often have underlying acute and chronic illness, stress related catabolism, decreased appetite, trauma and ongoing inflammation. Malnutrition is recognized as a leading cause of adverse outcomes, higher mortality, and increased hospital costs. Percutaneous endoscopic gastrostomy (PEG) tubes provide a safe and effective route to provide supplemental enteral nutrition to these patients. PEG placement has essentially replaced surgical gastrostomy as the modality of choice for longer term feeding in patients. This is a highly prevalent procedure with 160,000 to 200,000 PEG procedures performed each year in the United States. The purpose of this review is to provide an overview of current knowledge and practice standards with regards to placement of PEG tube in the Intensive Care Unit (ICU). When a patient is considered for a PEG tube, it is important to evaluate the treatment alternatives and identify the best option for each patient. In this review, we provide the advantages and disadvantages of various feeding modalities and devices. We review the indications and contraindications for PEG tube placement as well as the risks of this procedure. We then describe in detail the per-oral pull, per-oral push, and direct percutaneous techniques for PEG tube placement. Additionally, we review the feasibility of having interventional pulmonologists place PEG tubes in the ICU.

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“…Внедрение в рутинную практику интенсивной терапии методики пункционно-дилатационной трахеостомии (ПДТ) почти полностью вытеснило операцию открытой хирургической трахеостомии [44]. Это привело к снижению частоты периоперационных кровотечений, стенозов трахеи и инфицирования мягких тканей и средостения [45]. Следует помнить, что ПДТ должны выполняться только при бронхоскопической ассистенции и под УЗИ-контролем.…”

Section: доступ к дыхательным путям неинвазивная и инвазивная ивлunclassified

Topical respiratory strategies in neurocritical care

et al. 2017

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Management of the respiratory tract and maintenance of adequate gas exchange are the basic goals of critical care. Injury to the nervous system is often accompanied by development of respiratory disorders. On the other hand, changes in the gas composition of arterial blood can cause brain damage. In addition, approaches to the patient with respiratory failure, which are used in general critical care and neurocritical care, may differ. The presented literature review is devoted to modern respiratory strategies used in neurocritical care.

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Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy

Cited by 8 publications

References 52 publications

Use of Tracheostomy During the COVID-19 Pandemic

Use of Tracheostomy During the COVID-19 Pandemic

An overview of percutaneous endoscopic gastrostomy tube placement in the intensive care unit

Topical respiratory strategies in neurocritical care

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