Percutaneous ultrasound-guided versus bronchoscopy-guided dilatational tracheostomy after median sternotomy: A case-control study

Bermede, Onat; Sarıcaoğlu, Mehmet Cahit; Baytaş, Volkan; Hasde, Ali Ihsan; İnan, Mustafa; Akar, Ahmet

doi:10.5606/tgkdc.dergisi.2021.21951

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Surgical tracheostomy has been widely used and was described to be easily performed also in difficult scenarios such as COVID-19 ICUs during the coronavirus pandemic [ 76 ]. Percutaneous techniques have been growing in popularity in the last 20 years, but their ability to improve relevant outcomes is still debated [ 77 , 78 ]. Finally, Molardi et al proposed a hybrid technique to reduce hemorrhagic and infectious complications, such as sternotomy wound infection, in cardiac surgery patients [ 75 ].…”

Section: Prolonged Ventilation and Tracheostomymentioning

confidence: 99%

Difficult Respiratory Weaning after Cardiac Surgery: A Narrative Review

Nicolotti

Grossi

Nicolini

et al. 2023

JCM

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Respiratory weaning after cardiac surgery can be difficult or prolonged in up to 22.7% of patients. The inability to wean from a ventilator within the first 48 h after surgery is related to increased short- and long-term morbidity and mortality. Risk factors are mainly non-modifiable and include preoperative renal failure, New York Heart Association, and Canadian Cardiac Society classes as well as surgery and cardio-pulmonary bypass time. The positive effects of pressure ventilation on the cardiovascular system progressively fade during the progression of weaning, possibly leading to pulmonary oedema and failure of spontaneous breathing trials. To prevent this scenario, some parameters such as pulmonary artery occlusion pressure, echography-assessed diastolic function, brain-derived natriuretic peptide, and extravascular lung water can be monitored during weaning to early detect hemodynamic decompensation. Tracheostomy is considered for patients with difficult and prolonged weaning. In such cases, optimal patient selection, timing, and technique may be important to try to reduce morbidity and mortality in this high-risk population.

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Section: Prolonged Ventilation and Tracheostomymentioning

confidence: 99%

Difficult Respiratory Weaning after Cardiac Surgery: A Narrative Review

Nicolotti

Grossi

Nicolini

et al. 2023

JCM

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“…sound during PDT (26). Another two trials comparing ultrasonography and bronchoscopy for PDT showed no significant difference in procedure time or complications (27,28). Furthermore, Klotz et al (29) mentioned that bronchoscopy may reduce the safety of the PDT procedure.…”

Section: Discussionmentioning

confidence: 99%

Tracheostomy Preferences of Anesthesiology and Reanimation Specialists in Türkiye

Abdullayev,

Kelleci,

Cakmak

et al. 2024

JARSS

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Objective: There has been a trend toward percutaneous tracheostomy in recent years, as anesthesiologists have been interested in this and learned the techniques. We aimed to investigate the perspectives of anesthesiology and reanimation specialists in our country regarding tracheostomy. Methods: A survey was conducted on Anesthesiology and Reanimation specialists, which included questions of tracheostomy experience, preferences. Chi-square or Fisher tests were used for analysis. Results: A total of 213 people (51.2% women) participated, where 29% preferred tracheostomy within the two weeks of intubation, while 66% preferred it later. While 87% of the participants preferred percutaneous tracheostomy, 11% preferred surgical technique. For the specialists who preferred tracheostomy within the first two weeks of intubation, the rate of working in a university hospital was significantly higher (p=0.034). Of those who preferred surgical tracheostomy 91.3% had 0-10 times tracheostomy experience. While 89% of the participants preferred needle, 7% preferred scalpel cricothyrotomy. Conclusion: Tracheostomy is a commonly used procedure by anesthesiologists and intensivists. Bronchoscopy and ultrasonography are frequently used auxiliary tools. University hospital physicians often prefer tracheostomy within the first two weeks of intubation. Those with more tracheostomy experience mostly use the percutaneous method. Contrary to the current guidelines, needle method is preferred for cricothyrotomy in our country. Keywords: Complication, experience, percutaneous, surgery, tracheostomy

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“…In this case, intervention can only be based on anatomical signs. A review of the literature showed that there are studies comparing the use of anatomical landmarks, USG, or FOB during PDT in terms of safety, duration, or development of complications [11][12][13]. However, no study was found that focuses on evaluating the effect of the morphological structure of individuals on the PDT intervention location and complications.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effect of Morphological Structure on Dilatational Tracheostomy Interference Location and Complications with Ultrasonography and Fiberoptic Bronchoscopy

Bulut,

Arslan Yildiz,

Cengiz

et al. 2024

JCM

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Background: Percutaneous dilatational tracheostomy (PDT) is the most commonly performed minimally invasive intensive care unit procedure worldwide. Methods: This study evaluated the percentage of consistency between the entry site observed with fiberoptic bronchoscopy (FOB) and the prediction for the PDT level based on pre-procedural ultrasonography (USG) in PDT procedures performed using the forceps dilatation method. The effect of morphological features on intervention sites was also investigated. Complications that occurred during and after the procedure, as well as the duration, site, and quantity of the procedures, were recorded. Results: Data obtained from a total of 91 patients were analyzed. In 57 patients (62.6%), the USG-estimated tracheal puncture level was consistent with the intercartilaginous space observed by FOB, while in 34 patients (37.4%), there was a discrepancy between these two methods. According to Bland Altman, the agreement between the tracheal spaces determined by USG and FOB was close. Regression formulas for PDT procedures defining the intercartilaginous puncture level based on morphologic measurements of the patients were created. The most common complication related to PDT was cartilage fracture (17.6%), which was proven to be predicted with maximum relevance by punctured tracheal level, neck extension limitation, and procedure duration. Conclusions: In PDT procedures using the forceps dilatation method, the prediction of the PDT intervention level based on pre-procedural USG was considerably in accordance with the entry site observed by FOB. The intercartilaginous puncture level could be estimated based on morphological measurements.

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Percutaneous ultrasound-guided versus bronchoscopy-guided dilatational tracheostomy after median sternotomy: A case-control study

Cited by 5 publications

References 18 publications

Difficult Respiratory Weaning after Cardiac Surgery: A Narrative Review

Difficult Respiratory Weaning after Cardiac Surgery: A Narrative Review

Tracheostomy Preferences of Anesthesiology and Reanimation Specialists in Türkiye

Evaluation of the Effect of Morphological Structure on Dilatational Tracheostomy Interference Location and Complications with Ultrasonography and Fiberoptic Bronchoscopy

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