Comparison Between Bronchoscopy and Real- Time Ultrasound Guided Percutaneous Tracheostomy

Keywords

• tracheostomy
• complications
• ultrasound
• bronchoscopy

Lead sponsor

This is the only study on the registry with Aykut Saritas as lead sponsor.

Study arms

• Experimental
  Ultrasound

  Ultrasound guided percutaneous tracheostomy

  Device: Ultrasound guided percutaneous tracheostomy

• Active comparator
  Bronchoscopy

  Bronchoscopy guided percutaneous tracheostomy

  Device: Bronchoscopy guided percutaneous tracheostomy

Interventions

• DeviceUltrasound guided percutaneous tracheostomy

  Ultrasound guided percutaneous tracheostomy

• DeviceBronchoscopy guided percutaneous tracheostomy

  Bronchoscopy guided percutaneous tracheostomy

Primary outcomes

1. procedure failure of ultrasound to provide this anatomical information and ease of perform

   occurence of a major complications: bleeding, subcutaneous emphysema, oesophageal perforation, number of applied needle interventions, procedure duration, cardiorespiratory arrest

   Time frame: During percutaneous tracheostomy an expected average time 20 minutes

Secondary outcomes

1. procedure time

   the procedure duration was taken as the time that elapsed from the placement of the needle to the placement of the tracheostomy cannula.

   Time frame: during percutaneous tracheostomy ( average expected time 20 minutes)

2. Pneumothorax

   Pneumothorax due to the percutaneous tracheostomy detected by clinical examination during the procedure or chest x-ray after the procedure.

   Time frame: Participants will be followed for the duration of hospital stay, an expected average of 4 weeks

3. Tracheal posterior wall injury

   Tracheal posterior wall injury as detected by bronchoscopy after the procedure

   Time frame: Participants will be followed for the duration of hospital stay, an expected average of 4 weeks

4. Accidental decannulation

   Accidental decannulation after the procedure during Hospital stay

   Time frame: Participants will be followed for the duration of hospital stay, an expected average of 4 weeks

5. Cardiorespiratory arrest

   Cardiorespiratory arrest due to percutaneous tracheostomy

   Time frame: during percutaneous tracheostomy an expected average of 20 minutes

6. Minor bleeding

   Haemorrhage that could not be stopped by sponge wrapping the stoma after the procedure and/or blood coming with aspiration inside the tracheostomy tube was defined as minor bleeding

   Time frame: Participants will be followed for the duration of hospital stay, an expected average of 4 weeks

7. Major bleeding

   Continuous haemorrhage from the stoma and/or from the trachea with aspiration despite compresses was defined as a major haemorrhage.

   Time frame: During the procedure an expected average of 20 minutes

Other outcomes

1. Hypoxemia

   Drop in peripheral oxygen saturation \< 90% for more than 2 minutes as measured by pulse oximeter during the procedure

   Time frame: During percutaneous tracheostomy an expected average of 20 minutes

Publications

• Ravi PR, Vijay MN. Real time ultrasound-guided percutaneous tracheostomy: Is it a better option than bronchoscopic guided percutaneous tracheostomy? Med J Armed Forces India. 2015 Apr;71(2):158-64. doi: 10.1016/j.mjafi.2015.01.013. Epub 2015 Mar 12. PubMed 25859079 ↗
• Gobatto AL, Besen BA, Tierno PF, Mendes PV, Cadamuro F, Joelsons D, Melro L, Park M, Malbouisson LM. Comparison between ultrasound- and bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients: a retrospective cohort study. J Crit Care. 2015 Feb;30(1):220.e13-7. doi: 10.1016/j.jcrc.2014.09.011. Epub 2014 Sep 22. PubMed 25306240 ↗
• Flint AC, Midde R, Rao VA, Lasman TE, Ho PT. Bedside ultrasound screening for pretracheal vascular structures may minimize the risks of percutaneous dilatational tracheostomy. Neurocrit Care. 2009 Dec;11(3):372-6. doi: 10.1007/s12028-009-9259-z. Epub 2009 Aug 13. PubMed 19680824 ↗

Individual participant data

Plan to share: Undecided