ISSN 2407-2230 | E-ISSN 1907-3062 | Universa Medicina content is searchable on DOAJ, Google Scholar, and OAI

Safety of bronchoscopic guided percutaneous dilatational tracheostomy in ICU patients in Tabriz City

Mohammad Esmaeil Hejazi, Mohammadamin Rezazadehsaatlou, Leila Namvar, Armin Sadeghi, Veghar Hejazi, Yasin Hejazi, Katrin Buyuk Aghazadeh
Submission date: Monday, 14 August 2017
Published date: Monday, 30 October 2017
DOI: http://dx.doi.org/10.18051/UnivMed.2017.v36.173-178

Abstract


BACKGROUND
Tracheostomy is one of the most frequently performed procedures in intensive care units. The widespread attraction of percutaneous dilatational tracheostomy (PDT) is increasing in modern intensive care units (ICU). Bronchoscopic guidance seems to secure the safety of the technique. Multiple studies done to explain characterize differences in complications and cost-effectiveness of open and percutaneous tracheotomy. The objective of this study was to evaluate the benefits of percutaneous dilatational tracheostomy (PDT) using the Ciaglia technique with bronchoscopic guidance.

METHODS
A total of 100 elective percutaneous dilatational tracheostomies using the Ciaglia technique with a little modification were performed under flexible fiber optic bronchoscopic guide. The demographic variables were recorded, the underlying cause for patient’s referred to the center for PDT, and intraoperative as well as early postoperative complications. Patients followed for several days after tracheostomy for early complications.

RESULTS
No severe complications related to percutaneous dilatational tracheostomy were noticed during and after the procedure. Three patients had bleeding during incision and two led to subcutaneus hematoma. There were no other complications such as infection, emphysema and puncture of  posterior wall.

CONCLUSIONS
We recommended the use of endoscopic guidance bedside percutaneous tracheostomy using the Ciaglia technique with a little modification because it is safe and simple to do without significant complications. PDT with bronchoscopic guidance is a safe and easy procedure that can be done at the bedside setting.

Keywords


Percutaneous dilatational tracheostomy; bronchoscopy; complication

Full Text:

PDF

References


Frost EA. Tracing the tracheostomy. Ann Otol Rhinol Laryngol 1976;85(5 Pt.1):618-24.

Nowak A, Kern P, Koscielny S, et al. Feasibility and safety of dilatational tracheotomy using the rigid endoscope: amulticenter study. BMC Anesthesiol 2017;7:17. DOI: 10.1186/s12871-017-0301-y.

Putensen C, Theuerkauf N, Guenther U, et al. Percutaneous and surgical tracheostomy in critically ill adult patients: a meta-analysis. Critical Care 2014;18:544. doi:10.1186/s13054-014-0544-7.

Brass P1, Hellmich M, Ladra A, et al. Percutaneous techniques versus surgical techniques for tracheostomy. Cochrane Database Syst Rev 2016;7:CD008045. doi: 10.1002/14651858. CD008045.pub2.

Kiran S1, Eapen S1, Chopra V1. A comparative study of complications and long term outcomes of surgical tracheostomy and two techniques of percutaneous tracheostomy. Indian J Crit Care Med 2015;19:82-6. doi: 10.4103/0972-5229.151015.

Pilarczyk K, Carstens H, Heckmann J, et al. Safety and efficiency of percutaneous dilatational tracheostomy with direct bronchoscopic guidance for thoracic transplant recipients. Respir Care 2016;61:235–42. DOI: 10.4187/respcare.04128.

Acharya D, Nanjangud P. Percutaneous tracheostomy. Ind J Resp Care 2014; 3:488-96.

Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest 1985;87:715-9,

Ciaglia P. Technique, complications, and improvements in percutaneous dilatational tracheostomy. Chest 1999;115:1229-30.

Gromann TW, Birkelbach O, Hetzer R. Balloon dilatational tracheostomy: initial experience with the Ciaglia Blue Dolphin method. Anesth Analg 2009;108:1862-6.

Susarla SM, Peacock ZS, Alam HB. Percutaneous dilatational tracheostomy: review of technique and evidence for its use. J Oral Maxillofac Surg 2012;70:74-82.

Klotz R, Klaiber U, Grummich K, et al. Percutaneous versus surgical strategy for tracheostomy: protocol for a systematic review and meta-analysis of perioperative and postoperative complications. Syst Rev 2015;4:105. doi: 10.1186/s13643-015-0092-5.

Rajajee V, Fletcher JJ, Rochlen LR, et al. Real-time ultrasound-guided percutaneous dilatational tracheostomy: a feasibility study. Crit Care 2011;15:R67. doi: 10.1186/cc10047.

Byhahn C. Percutaneous tracheostomy: the Ciaglia techniques. In: Servillo G, Pelosi P,editors. Percutaneous tracheostomy in critically illpatients. New York: Springer International Publishing Switzerland;2016.p.37-41.

Higgins KM, Punthakee X. Meta-analysis comparison of open versus percutaneous tracheostomy. Laryngoscope 2007;117:447-54.

Mirski MA, Pandian V, Bhatti N, et al. Safety, efficiency, and cost-effectiveness of a multidisciplinary percutaneous tracheostomy program. Crit Care Med 2012;40:1827-34.


Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 Universa Medicina

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Creative Commons License
Universa Medicina by Faculty of Medicine, Trisakti University is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Based on a work at https://univmed.org/ejurnal/index.php/medicina/