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Percutaneous dilation tracheostomy

Vinciya Pandian, Christoph T Hutchinson, Adam J Schiavi, David J Feller-Kopman, Elliott R Haut, Nicole A Parsons, Jessica S Lin, Chad Gorbatkin, Priya G Angamuthu, Christina R Miller, Marek A Mirski, Nasir I Bhatti, Lonny B Yarmus
PURPOSE: Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early tracheostomy tube change, possible bleeding, or loss of the airway. We sought to identify predictors of nonstandard tracheostomy tubes. MATERIALS AND METHODS: In this matched case-control study at an urban, academic, tertiary care medical center, we reviewed 1220 records of patients who received a tracheostomy...
June 4, 2016: Journal of Critical Care
Andreas Schaefer, Yvonne Schneeberger, Daniel Reichart, Alexander M Bernhardt, Mathias Kubik, Markus J Barten, Florian M Wagner, Stefan Kluge, Hermann Reichenspurner, Sebastian A Philipp
Over the last decade the number of heart transplantations declined and the number of implanted left ventricular assist devices (LVAD) markedly increased. Accordingly, common intensive care interventions rise and present their own challenges, especially due to the necessary anticoagulation regimen. One of these procedures is percutaneous dilatation tracheostomy (PDT). We herein report our experience with 34 patients with LVAD and established phrenprocoumon therapy (INR 2.1 ± 0.9, PTT 68.9 ± 19.0 sec...
August 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Achim Lother, Tobias Wengenmayer, Christoph Benk, Christoph Bode, Dawid L Staudacher
BACKGROUND: Tracheostomy is recommended in case of prolonged mechanical ventilation. Therefore, most patients with an indication for venovenous extracorporeal membrane oxygenation (ECMO) will also have an indication for tracheostomy. CASE PRESENTATION: We report 2 cases of fatal air embolism into the ECMO system as complication of percutaneous dilatational tracheostomy. Both patients had an AVALON ELITE® bi-caval cannula implanted draining blood from the vena cava superior and inferior...
2016: Journal of Cardiothoracic Surgery
Prakash K Dubey, Om P Sanjeev
No abstract text is available yet for this article.
June 2016: Indian Journal of Critical Care Medicine
Gulnur Gollu, Ufuk Ates, Ozlem S Can, Tanil Kendirli, Aydin Yagmurlu, Murat Cakmak, Tanju Aktug, Hüseyin Dindar, Meltem Bingol-Kologlu
OBJECTIVE: The aim of this study is to report prospective data of pediatric cases that underwent percutaneous tracheostomy (PT) to show that PT is a safe and feasible procedure in children even in small infants. PATIENTS AND METHODS: PT was done in 51 consecutive patients. Demographic data, indications, complications and outcome were recorded prospectively. Initial 6 PT was done by Giaglia technique whereas the Griggs technique was used in the consecutive 45 patients...
October 2016: Journal of Pediatric Surgery
Tino Klancir, Višnja Nesek Adam, Viviana Mršić, Damjan Marin, Tatjana Goranović
Percutaneous dilatational tracheostomy is a common surgical procedure that is becoming the method of choice in critically ill patients whenever prolonged airway secure and/or ventilation support is needed. Although adverse events are relatively uncommon, serious life threatening complications can arise from this bedside procedure. We report a case of a 70-year-old female who developed extensive subcutaneous emphysema and bilateral pneumothorax immediately after a percutaneous dilatational tracheostomy procedure...
March 2016: Acta Clinica Croatica
Woosuk Chung, Byung Muk Kim, Sang-Il Park
When first introduced, percutaneous dilatational tracheostomy (PDT) was performed using a bronchoscope. The bronchoscope itself, however, has several disadvantages, including interruption of ventilation. Modifications of the standard PDT technique have suggested that PDT can be safely performed without a bronchoscope. However, the safety of these modifications is unclear and many modifications have yet to be widely adopted. This study retrospectively evaluated the safety of a simplified PDT technique using the Cook® Ciaglia Blue Rhino™ in 186 patients...
June 2016: Korean Journal of Anesthesiology
A F Fiorelli, F F Ferraro, R M Milione, R S Scarumuzzi, P I Imitazione, L M Marulli, A O Orsini, M S Santini
The ETView(®) tube is a standard endotracheal tube with an embedded miniature video camera that permits real-time video imaging of the tracheal lumen. We evaluated its use when performing percutaneous dilatational tracheostomy (PDT) in an ex vivo animal model. The model consisted of a pig larynyx and trachea. The ETView tube was used as an alternative to bronchoscopy, to see all manoeuvres of PDT in real time. At the end of the PDT, operative time and any complications such as trauma to the cricoid cartilage, tracheal wall or tube cuff were assessed...
May 2016: Anaesthesia and Intensive Care
A Ujam, M Perry
PURPOSE: Submental intubation is widely accepted as a safe and effective alternative to nasal intubation or tracheostomy in head and neck surgery patients. Forceful or careless technique can cause significant bleeding and trauma to the soft tissues at this point, increasing the likelihood of troublesome sublingual haematoma. METHODS: We describe the use of a percutaneous tracheostomy horn (Cook Medical Blue Rhino(®)) to allow minimally traumatic submental intubation without the need for serial dilations...
April 30, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Tarik Umutoglu, Mefkur Bakan, Ufuk Topuz, Sinan Yilmaz, Kadir Idin, Selcuk Alver, Erdogan Ozturk, Ziya Salihoglu
Fiberoptic bronchoscopy (FOB) via endotracheal tube (ETT) is the most frequent utilized technique for monitoring of percutaneous dilatational tracheostomy (PDT) procedure while maintaining mechanical ventilation. Endoscopic guidance has increased the safety of this procedure; nevertheless, the use of a bronchoscope via ETT potentially may deteriorate ventilation and lead to hypercarbia and/or hypoxia. EtView tracheoscopic ventilation tube (EtView TVT) is a standard endotracheal tube with a camera and light source embedded at the tip...
April 29, 2016: Journal of Clinical Monitoring and Computing
Binita Panigrahi, Devi Prasad Samaddar, Tushar Kumar
Percutaneous dilatational tracheostomy is a commonly performed bedside procedure in the Intensive Care Unit. Although serious and fatal complications have been reported, the procedure is by and large safe to perform in experienced hands. We report here an innocuous problem encountered twice. After the guidewire insertion and dilatation, subsequent railroading became difficult owing to migration of guidewire into the Murphy's eye of the endotracheal tube (ETT). Awareness about this possibility can avert inadvertent delays and complications during the procedure...
March 2016: Indian Journal of Critical Care Medicine
Stephanie Johnson-Obaseki, Andrea Veljkovic, Hedyeh Javidnia
BACKGROUND: In the setting of critical care, the most common indications for tracheostomy include: prolonged intubation, to facilitate weaning from mechanical ventilation, and for pulmonary toileting. In this setting, tracheostomy can be performed either via open surgical or percutaneous technique. Advantages for percutaneous dilatational tracheostomy (PDT) include: simplicity, smaller incision, less tissue trauma, lower incidence of wound infection, lower incidence of peristomal bleeding, decreased morbidity from patient transfer, and cost-effectiveness...
April 14, 2016: Laryngoscope
K Pilarczyk, N Haake, M Dudasova, B Huschens, D Wendt, E Demircioglu, H Jakob, F Dusse
Bleeding complications after percutaneous dilatational tracheostomy (PDT) are infrequent but may have a tremendous impact on a patient's further clinical course. Therefore, it seems necessary to perform risk stratification for patients scheduled for PDT. We retrospectively reviewed the records of 1001 patients (46% male, mean age 68.1 years) undergoing PDT (using the Ciaglia Blue Rhino® technique with direct bronchoscopic guidance) in our cardiothoracic ICU between January 2003 and February 2013. Patients were stratified into two groups: patients suffering acute moderate, severe, or major bleeding (Group A) and patients who had no or only mild bleeding (Group B)...
March 2016: Anaesthesia and Intensive Care
Graeme A Browne
Quick response tracheostomy (QRT) is a novel open surgical technique to emergently establish an airway. The method is simple; the skills necessary to perform this procedure are rapidly acquired; and it is expedient, minimally traumatic, and remarkably devoid of complications often encountered with percutaneous dilatational tracheotomies, including those complications seen with cricothyroidotomies. Unlike all other tracheotomies in which considerable blunt dissection is required, QRT avoids tissue crushing because sharp dissection alone is used to acquire surgical access to the trachea...
May 2016: Journal of Intensive Care Medicine
Anis Dizdarevic, Parwane Pagano, Shivang Desai
Bronchoscopic-guided percutaneous dilational tracheostomy has become one of the most common elective tracheostomy methods for patients requiring prolonged ventilatory support. The safety profile, patient selection, and risks as well as complication management, when compared with an open surgical technique, remain somewhat controversial with no clear recommendations. We present a case of a critically ill patient undergoing percutaneous dilation tracheostomy complicated by tracheal wall injury and airway loss...
February 15, 2016: A & A Case Reports
Lachmandath Tewarie, Rachad Zayat, Helga Haefner, Jan Spillner, Andreas Goetzenich, Rüdiger Autschbach, Ajay Moza
No abstract text is available yet for this article.
2016: Journal of Cardiothoracic Surgery
André Luiz Nunes Gobatto, Bruno A M P Besen, Paulo F G M M Tierno, Pedro V Mendes, Filipe Cadamuro, Daniel Joelsons, Livia Melro, Maria J C Carmona, Gregorio Santori, Paolo Pelosi, Marcelo Park, Luiz M S Malbouisson
PURPOSE: Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopy guidance. Recently, ultrasound has emerged as a potentially useful tool to assist PDT and reduce procedure-related complications. METHODS: An open-label, parallel, non-inferiority randomized controlled trial was conducted comparing an ultrasound-guided PDT with a bronchoscopy-guided PDT in mechanically ventilated critically ill patients. The primary outcome was procedure failure, defined as a composite end-point of conversion to a surgical tracheostomy, unplanned associated use of bronchoscopy or ultrasound during PDT, or the occurrence of a major complication...
March 2016: Intensive Care Medicine
Kevin Pilarczyk, Henning Carstens, Jens Heckmann, Juri Lubarski, Günter Marggraf, Heinz Jakob, Nikolaus Pizanis, Markus Kamler
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is the standard airway access in critically ill patients who require prolonged mechanical ventilation. However, the literature lacks reports about the effectiveness and safety of this procedure in thoracic organ transplant recipients, who have increased risks of bleeding and infection. METHODS: We retrospectively reviewed the records of subjects who underwent thoracic organ transplantation at our institution between January 2004 and March 2011 followed by PDT (using the Ciaglia Blue Rhino technique with direct bronchoscopic guidance)...
February 2016: Respiratory Care
Aykut Saritas, Pelin Uzun Saritas, Muhammed Murat Kurnaz, Serbulent Gokhan Beyaz, Tolga Ergonenc
OBJECTIVE: To evaluate percutaneous dilatational tracheostomy with and without the use of the bronchoscope and compare the safety and complications of the procedure. METHODS: The prospective, randomised-controlled study was conducted at the Professor A. Ilhan Ozdemir State Hospital, Giresun, Turkey, between October 2013 and February 2014, and comprised patients ≥18 years of age who were dependent on mechanical ventilation for an extended duration and were scheduled to undergo percutaneous dilatational tracheostomy with Griggs technique...
January 2016: JPMA. the Journal of the Pakistan Medical Association
Youbai Chen, Haizhong Zhang
Tracheostomy is to establish an artificial airway by making an opening at anterior tracheal wall. Due to the blossom of mechanical ventilation and intensive care unit after 1950s, tracheostomy is the most favorable surgical method to access airway at present. In addition to traditional surgical tracheostomy, percutaneous dilational tracheostomy have gained increasing popularity and become an alternative procedure because of its merits such as easier manipulation, shorter operative duration and less complications...
September 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
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