Comparison of Bronchoscopy-Guided and Real-Time Ultrasound-Guided Percutaneous Dilatational Tracheostomy: Safety, Complications, and Effectiveness in Critically Ill Patients

2017 ◽  
Vol 34 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Aykut Sarıtaş ◽  
Muhammed M. Kurnaz
Keyword(s):  
Real Time ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Percutaneous Dilatational Tracheostomy ◽  
Apache Ii ◽  
Ultrasound Guided ◽  
Dilatational Tracheostomy ◽  
The Us ◽  
The Mean

Objective: To compare the efficacy, safety, and incidence of complications between fiber-optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) and ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) and to determine whether US-PDT is a viable alternative to FOB-PDT. Methods: This randomized prospective study was carried out in 80 patients who were randomly divided into US-PDT and FOB-PDT groups. Demographic data and Acute Physiology and Chronic Health Evaluation II (APACHE II), procedure duration, hemorrhage status, complications, procedure difficulty, displacement of entry location after US, and hemodynamic data were evaluated in both groups. Tracheal incision was performed with real-time US and a transverse probe position in the out-of-plane mode. Results: No significant differences were observed between the 2 groups in terms of demographic data, oral intubation time, APACHE II values, difficulty of the procedure, or the number of needle interventions ( P > .05). The mean hemorrhage ratio of the FOB-PDT group was significantly higher than that of the US-PDT group ( P < .05). The entry location was changed in 6 patients in the US-PDT group following neck examination with US. The mean duration of the procedure for the FOB-PDT group was significantly longer than that for the US-PDT group ( P < .05). Conclusion: Ultrasound-guided percutaneous dilatational tracheostomy is a safe procedure for critically ill patients and has the advantages of a low complication rate, short duration of procedure, being informative with regard to neck anatomy, and facilitating prevention of vascular puncture. Thus, US-PDT can be used as an alternative to FOB-PDT.

scholarly journals A comparative review of the literature surrounding complications associated with percutaneous dilatational tracheostomy versus open surgical tracheostomy

2018 ◽  
Vol 8 (1) ◽  
pp. 5-11
Author(s):  
Holly  Newton ◽  
Shadaba Ahmed
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Surgical Procedure ◽  
Percutaneous Dilatational Tracheostomy ◽  
Review Of The Literature ◽  
Surgical Tracheostomy ◽  
Dilatational Tracheostomy ◽  
Comparative Review ◽  
Open Surgical Tracheostomy

In this structured review, I aim to discuss the principle of tracheostomies including what they are and why we perform them. My main objective is to explore the literature surrounding whether or not there is a better option between open surgical and percutaneous dilatational tracheostomy, based on the complications with which they are associated. Simply put, a tracheostomy is a common surgical procedure performed on critically ill patients in order to facilitate their breathing. I will discuss the two main types of tracheostomy: open surgical (OST) and percutaneous dilatational (PDT), along with their accompanying impediments. 

Percutaneous dilatational tracheostomy in 139 critically ill patients: evaluation of our experience

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 156
Author(s):  
L. M. Farina ◽  
M. Piastra ◽  
G. Leopizzi ◽  
L. Costanzo ◽  
R. Farina ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Percutaneous Dilatational Tracheostomy ◽  
Dilatational Tracheostomy

scholarly journals Feasibility, tolerance and effectiveness of enteral feeding in critically ill patients in prone position

2020 ◽  
pp. 175114371990010 ◽  
Author(s):  
Raymond Dominic Savio ◽  
Rajalakshmi Parasuraman ◽  
Daphnee Lovesly ◽  
Bhuvaneshwari Shankar ◽  
Lakshmi Ranganathan ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Prone Position ◽  
Supine Position ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Apache Ii ◽  
Apache Ii Score ◽  
The Mean

Aim To assess the feasibility, tolerance and effectiveness of enteral nutrition in critically ill patients receiving invasive mechanical ventilation in the prone position for severe Acute Respiratory Distress Syndrome (ARDS). Methods Prospective observational study conducted in a multidisciplinary critical care unit of a tertiary care hospital from January 2013 until July 2015. All patients with ARDS who received invasive mechanical ventilation in prone position during the study period were included. Patients’ demographics, severity of illness (Acute Physiology and Chronic Health Evaluation (APACHE II) score), baseline markers of nutritional status (subjective global assessment (SGA) and body mass index), details of nutrition delivery during prone and supine hours and outcomes (Length of stay and discharge status) were recorded. Results Fifty-one patients met inclusion criteria out of whom four patients were excluded from analysis since they did not receive any enteral nutrition due to severe hemodynamic instability. The mean age of patients was 46.4 ± 12.9 years, with male:female ratio of 7:3. On admission, SGA revealed moderate malnutrition in 51% of patients and the mean APACHE II score was 26.8 ± 9.2. The average duration of prone ventilation per patient was 60.2 ± 30.7 h. All patients received continuous nasogastric/orogastric feeds. The mean calories (kcal/kg/day) and protein (g/kg/day) prescribed in the supine position were 24.5 ± 3.8 and 1.1 ± 0.2 while the mean calories and protein prescribed in prone position were 23.5 ± 3.6 and 1.1 ± 0.2, respectively. Percentage of prescribed calories received by patients in supine position was similar to that in prone position (83.2% vs. 79.6%; P = 0.12). Patients received a higher percentage of prescribed protein in supine compared to prone position (80.8% vs. 75%, P = 0.02). The proportion of patients who received at least 75% of the caloric and protein goals was 37 (78.7%) and 37 (78.7%) in supine and 32 (68.1%) and 21 (44.6%) in prone position. Conclusion In critically ill patients receiving invasive mechanical ventilation in the prone position, enteral nutrition with nasogastric/orogastric feeding is feasible and well tolerated. Nutritional delivery of calories and proteins in prone position is comparable to that in supine position.

scholarly journals Characteristics of Critically-Ill Patients at Two Tertiary Care Hospitals in Sudan

2018 ◽  
Vol 18 (2) ◽  
pp. 190 ◽  
Author(s):  
Hagir Sulieman ◽  
Wael El-Mahdi ◽  
Mohannad Awadelkareem ◽  
Lama Nazer
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Apache Ii ◽  
The Mean ◽  
Tertiary Care Hospitals

Objectives: Knowledge of intensive care unit (ICU) admission patterns and characteristics is necessary for the development of critical care services, particularly in low-resource settings. This study aimed to describe the characteristics of critically-ill patients admitted to ICUs in Sudan. Methods: This prospective observational study was conducted between February and May 2017 in the ICUs of two government tertiary care hospitals inKhartoum, Sudan. A total of 100 consecutive adult patients admitted to the ICUs were included in the study. The patients’ demographic and clinical characteristics and Acute Physiologic Assessment and Chronic Health Evaluation (APACHE II) scores upon admission were recorded, as well as the reason for admission, presence of any underlying comorbidities, interventional requirements like mechanical ventilation or haemodialysis, length of stay in the ICU and patient outcome. Results: Of the sample, 58% were female and 42% were male. The mean age was 47.4 ± 18.3 years old. Upon admission, the mean APACHE II score was 14.2 ± 9.6. In total, 54% of the patients had no known underlying comorbidities. The most common reasons for ICU admission were neurological diseases (27%), sepsis or infectious diseases (19%) and postoperative management (12%). Mechanical ventilation and haemodialysis were required by 35% and 11% of the patients, respectively. The average length of stay was 10.0 ± 7.2 days and the mortality rate was 24%. Conclusion: Most of the patients admitted to the ICUs were middle-aged females with no known underlying comorbidities. Larger studies are necessary to provide a comprehensive understanding of the critical care needs of Sudanese hospitals.Keywords: Intensive Care Units; Patient Admission, trends; Critical Care Outcomes; Developing Countries; Sudan.

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