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Erschienen in:

11.01.2021 | original article

A clinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients

verfasst von: Xiu-Yu Du, MD, Xiao-Dong Zhai, MM, Zhi Liu, MM

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 15-16/2021

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Summary

Objective

This study aimed to introduce a novel tracheostomy method, the non-guide-wire percutaneous dilatational tracheostomy (NGPDT) technique, and evaluate its effectiveness for critically ill patients undergoing neurosurgery under special conditions.

Methods

The clinical data of 48 critically ill patients who underwent NGPDT under special conditions with controlled steps were analyzed retrospectively. The patients’ demographic, preoperative state of illness, and diagnosis data were collected. Moreover, their intraoperative and postoperative variables were accessed, e.g., operation times, bleeding, saturation of pulse oxygen (SPO2), and early and late complications related to NGPDT.

Results

The mean patient age was 47.7 ± 13.7 years. The mean GCS (Glasgow Coma Scale) was 8.1 ± 2.9, and the mean BMI (Body Mass Index) was 25.2 ± 5.6. There were 38 patients with an endotracheal tube. The mean duration of onset to NGPDT was 4.0 ± 1.3 days. The mean operation time was 4.2 ± 1.9 min. There were 41 patients with mild intraoperative bleeding, 5 with moderate bleeding, and 2 with severe bleeding as well as 46 with mild postoperative bleeding and 2 with moderate bleeding. Additionally, 41 patients required complete extubation after NGPDT. The mean duration of incision healing was 4.8 ± 3.1 days. There was 1 patient with a decrease of SPO2 ≥ 10%. Three patients presented with a transient violent cough at the primary tracheostomy stage; however, no patients suffered from pneumothorax, subcutaneous emphysema, false passage, or surgery-related death during this procedure.

Conclusion

Overall, NGPDT with controlled steps is a fast, safe, and microinvasive procedure. It mildly stimulates the trachea with a low rate of complications.
Literatur
1.
Zurück zum Zitat Vargas M, Sutherasan Y, Antonelli M, et al. Tracheostomy procedures in the intensive care unit: an international survey. Crit Care. 2015;19:291.CrossRef Vargas M, Sutherasan Y, Antonelli M, et al. Tracheostomy procedures in the intensive care unit: an international survey. Crit Care. 2015;19:291.CrossRef
2.
Zurück zum Zitat Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest. 1985;87:715–9.CrossRef Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest. 1985;87:715–9.CrossRef
3.
Zurück zum Zitat Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet. 1990;170:543–5.PubMed Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet. 1990;170:543–5.PubMed
4.
Zurück zum Zitat Byhahn C, Wilke HJ, Halbig S, Lischke V, Westphal K. Percutaneous tracheostomy: ciaglia blue rhino versus the basic ciaglia technique of percutaneous dilational tracheostomy. Anesth Analg. 2000;91:882–6.CrossRef Byhahn C, Wilke HJ, Halbig S, Lischke V, Westphal K. Percutaneous tracheostomy: ciaglia blue rhino versus the basic ciaglia technique of percutaneous dilational tracheostomy. Anesth Analg. 2000;91:882–6.CrossRef
5.
Zurück zum Zitat Frova G, Quintel M. A new simple method for percutaneous tracheostomy: controlled rotating dilation. A preliminary report. Intensive Care Med. 2002;28:299–303.CrossRef Frova G, Quintel M. A new simple method for percutaneous tracheostomy: controlled rotating dilation. A preliminary report. Intensive Care Med. 2002;28:299–303.CrossRef
6.
Zurück zum Zitat Saritas A, Saritas PU, Kurnaz MM, Beyaz SG, Ergonenc T. The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice. J Pak Med Assoc. 2016;66:83–9.PubMed Saritas A, Saritas PU, Kurnaz MM, Beyaz SG, Ergonenc T. The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice. J Pak Med Assoc. 2016;66:83–9.PubMed
7.
Zurück zum Zitat Chang SY, Sun RQ, Feng M, et al. The use of remifentanil in critically ill patients undergoing percutaneous dilatational tracheostomy: a prospective randomized-controlled trial. Kaohsiung J Med Sci. 2019;35:111–5.CrossRef Chang SY, Sun RQ, Feng M, et al. The use of remifentanil in critically ill patients undergoing percutaneous dilatational tracheostomy: a prospective randomized-controlled trial. Kaohsiung J Med Sci. 2019;35:111–5.CrossRef
8.
Zurück zum Zitat Al-Shathri Z, Susanto I. Percutaneous tracheostomy. Semin Respir Crit Care Med. 2018;39:720–30.CrossRef Al-Shathri Z, Susanto I. Percutaneous tracheostomy. Semin Respir Crit Care Med. 2018;39:720–30.CrossRef
9.
Zurück zum Zitat Cohen O, Shnipper R, Yosef L, et al. Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience. J Crit Care. 2018;47:127–32.CrossRef Cohen O, Shnipper R, Yosef L, et al. Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience. J Crit Care. 2018;47:127–32.CrossRef
10.
Zurück zum Zitat Johnson-Obaseki S, Veljkovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients. Laryngoscope. 2016;126:2459–67.CrossRef Johnson-Obaseki S, Veljkovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients. Laryngoscope. 2016;126:2459–67.CrossRef
11.
Zurück zum Zitat Ramakrishnan N, Singh JK, Gupta SK, et al. Tracheostomy: open surgical or percutaneous? An effort to solve the continued dilemma. Indian J Otolaryngol Head Neck Surg. 2019;71:320–6.CrossRef Ramakrishnan N, Singh JK, Gupta SK, et al. Tracheostomy: open surgical or percutaneous? An effort to solve the continued dilemma. Indian J Otolaryngol Head Neck Surg. 2019;71:320–6.CrossRef
12.
Zurück zum Zitat Maddali MM, Pratap M, Fahr J, Zarroug AW. Percutaneous tracheostomy by guidewire dilating forceps technique: review of 98 patients. J Postgrad Med. 2001;47:100–3.PubMed Maddali MM, Pratap M, Fahr J, Zarroug AW. Percutaneous tracheostomy by guidewire dilating forceps technique: review of 98 patients. J Postgrad Med. 2001;47:100–3.PubMed
13.
Zurück zum Zitat Mayberry JC, Wu IC, Goldman RK, Chesnut RM. Cervicalspine clearance and neck extension during percutaneoustracheostomy in trauma patients. Crit Care Med. 2000;28:3436–40.CrossRef Mayberry JC, Wu IC, Goldman RK, Chesnut RM. Cervicalspine clearance and neck extension during percutaneoustracheostomy in trauma patients. Crit Care Med. 2000;28:3436–40.CrossRef
14.
Zurück zum Zitat Hayaran N, Tanwar S, Singh R, Sardana R. Dilatational force in percutaneous tracheostomy: How much is too much? J Clin Anesth. 2019;52:51–2.CrossRef Hayaran N, Tanwar S, Singh R, Sardana R. Dilatational force in percutaneous tracheostomy: How much is too much? J Clin Anesth. 2019;52:51–2.CrossRef
15.
Zurück zum Zitat Rashid AO, Islam S. Percutaneous tracheostomy: a comprehensive review. J Thorac Dis. 2017;9:S1128–S38.CrossRef Rashid AO, Islam S. Percutaneous tracheostomy: a comprehensive review. J Thorac Dis. 2017;9:S1128–S38.CrossRef
16.
Zurück zum Zitat Sangwan YS, Chasse R. A modified technique for percutaneous dilatational tracheostomy: a retrospective review of 60 cases. J Crit Care. 2016;31:144–9.CrossRef Sangwan YS, Chasse R. A modified technique for percutaneous dilatational tracheostomy: a retrospective review of 60 cases. J Crit Care. 2016;31:144–9.CrossRef
17.
Zurück zum Zitat Pilarczyk K, Haake N, Dudasova M, et al. Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis. Anaesth Intensive Care. 2016;44:227–36.CrossRef Pilarczyk K, Haake N, Dudasova M, et al. Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis. Anaesth Intensive Care. 2016;44:227–36.CrossRef
18.
Zurück zum Zitat Añón JM, Gómez V, Escuela MP, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care. 2000;4:124–8.CrossRef Añón JM, Gómez V, Escuela MP, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care. 2000;4:124–8.CrossRef
19.
Zurück zum Zitat Muhammad JK, Major E, Wood A, Patton DW. Percutaneous dilatational tracheostomy: haemorrhagic complications and the vascular anatomy of the anterior neck. A review based on 497 cases. Int J Oral Maxillofac Surg. 2000;29:217–22.CrossRef Muhammad JK, Major E, Wood A, Patton DW. Percutaneous dilatational tracheostomy: haemorrhagic complications and the vascular anatomy of the anterior neck. A review based on 497 cases. Int J Oral Maxillofac Surg. 2000;29:217–22.CrossRef
20.
Zurück zum Zitat Pasin L, Frati E, Cabrini L, et al. Percutaneous tracheostomy in patients on anticoagulants. Ann Card Anaesth. 2015;18:329–34.CrossRef Pasin L, Frati E, Cabrini L, et al. Percutaneous tracheostomy in patients on anticoagulants. Ann Card Anaesth. 2015;18:329–34.CrossRef
21.
Zurück zum Zitat Du X, Yin S, Liu H. Applications of improved micro-invasive percutaneous tracheostomy in the obese, severe patients of neurosurgery. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015;29:1302–3. Article in Chinese.PubMed Du X, Yin S, Liu H. Applications of improved micro-invasive percutaneous tracheostomy in the obese, severe patients of neurosurgery. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015;29:1302–3. Article in Chinese.PubMed
22.
Zurück zum Zitat Iftikhar IH, Teng S, Schimmel M, Duran C, Sardi A, Islam S. A network comparative meta-analysis of percutaneous dilatational tracheostomies using anatomic landmarks, bronchoscopic, and ultrasound guidance versus open surgical tracheostomy. Lung. 2019;197:267–75.CrossRef Iftikhar IH, Teng S, Schimmel M, Duran C, Sardi A, Islam S. A network comparative meta-analysis of percutaneous dilatational tracheostomies using anatomic landmarks, bronchoscopic, and ultrasound guidance versus open surgical tracheostomy. Lung. 2019;197:267–75.CrossRef
23.
Zurück zum Zitat Aggarwal R, Soni KD, Goyal K, Singh GP, Sokhal N, Trikha A. Does real time ultrasonography confer any benefit during bronchoscopy guided percutaneous tracheostomy: a preliminary, randomized controlled trial. Indian J Crit Care Med. 2019;23:236–8.CrossRef Aggarwal R, Soni KD, Goyal K, Singh GP, Sokhal N, Trikha A. Does real time ultrasonography confer any benefit during bronchoscopy guided percutaneous tracheostomy: a preliminary, randomized controlled trial. Indian J Crit Care Med. 2019;23:236–8.CrossRef
24.
Zurück zum Zitat Rudas M, Seppelt I, Herkes R, Hislop R, Rajbhandari D, Weisbrodt L. Traditional landmark versus ultrasound guided tracheal puncture during percutaneous dilatational tracheostomy in adult intensive care patients: a randomised controlled trial. Crit Care. 2014;18:514.CrossRef Rudas M, Seppelt I, Herkes R, Hislop R, Rajbhandari D, Weisbrodt L. Traditional landmark versus ultrasound guided tracheal puncture during percutaneous dilatational tracheostomy in adult intensive care patients: a randomised controlled trial. Crit Care. 2014;18:514.CrossRef
Metadaten
Titel
A clinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients
verfasst von
Xiu-Yu Du, MD
Xiao-Dong Zhai, MM
Zhi Liu, MM
Publikationsdatum
11.01.2021
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 15-16/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-020-01799-3

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