Feasibility of Percutaneous Dilatational Tracheostomy with a Light Source in the Surgical Intensive Care Unit
Autor: | Suk-Kyung Hong, Nak-Jun Choi, Jung-Sun Lee, Minchang Kang, Jong-Kwan Baek |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Percutaneous medicine.diagnostic_test Light wand business.industry intensive care units light wand lcsh:Medical emergencies. Critical care. Intensive care. First aid Intensivist lcsh:RC86-88.9 Critical Care and Intensive Care Medicine Critical Care Nursing medicine.disease Intensive care unit law.invention Surgery Light source Bronchoscopy percutaneous dilatational tracheostomy law Medicine Original Article Airway business Laryngotracheal stenosis |
Zdroj: | Acute and Critical Care Acute and Critical Care, Vol 33, Iss 2, Pp 89-94 (2018) |
ISSN: | 2586-6060 |
Popis: | Background Although percutaneous dilatational tracheostomy (PDT) under bronchoscopic guidance is feasible in the intensive care unit (ICU), it requires extensive equipment and specialists. The present study evaluated the feasibility of performing PDT with a light source in the surgical ICU. Methods The study involved a retrospective review of the outcomes of patients who underwent PDT with a light source performed by a surgery resident under the supervision of a surgical intensivist in the surgical ICU from October 2015 through September 2016. During the procedure, a light wand was inserted into the endotracheal tube after skin incision. Then, the light wand and the endotracheal tube were pulled out slightly, the passage of light through the airway was confirmed, and the relevant point was punctured. Results Fifty patients underwent PDT with a light source. The average procedural duration was 14.0 ± 7.0 minutes. There were no procedure-associated deaths. Intraoperative complications included minor bleeding in three patients (6%) and paratracheal placement of the tracheostomy tube in one patient (2%); these were immediately resolved by the surgical intensivist. Two patients required conversion to surgical tracheostomy because of the difficulty in light wand insertion into the endotracheal tube and a very narrow trachea, respectively. Conclusions PDT with a light source can be performed without bronchoscopy and does not require expensive equipment and specialist intervention in the surgical ICU. It can be safely performed by a surgical intensivist with experience in surgical tracheostomy. |
Databáze: | OpenAIRE |
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