Citation Information :
Aggarwal R, Goyal K, Singh GP, Sokhal N. Does Real Time Ultrasonography Confer Any Benefit During Bronchoscopy Guided Percutaneous Tracheostomy: A Preliminary, Randomized Controlled Trial. Indian J Crit Care Med 2019; 23 (5):236-238.
Background: There are studies comparing USG guided percutaneous dilatational tracheostomy (PDT) with bronchoscopy guided PDT. We have compared USG guided PDT to conventional landmark guided PDT using bronchoscopy in both the groups.
Objective: The primary outcome was the time of procedure and the secondary outcome was incidence of complications in USG guided PDT in comparision to the conventional PDT.
Materials and Methods: Seventy adult patients were randomly allocated in two groups, i.e., conventional landmark percutaneous dilatational tracheostomy (PDT) and ultrasonography (USG) guided PDT. Demographic data, injury severity score, time taken for the procedure, attempts of tracheal puncture, major and minor complications, and outcome were compared.
Results: The median time taken for the procedure was 12 minutes [min., max.; 8, 20] in conventional group 1 and 16 minutes [9, 24] in group 2 (USG guided) which was statistically significant. Minor bleeding was seen in 7 (20%) patients in group 1 and only in 4 patients (11.5%) in group 2. The rate of other complications and the long term outcome were similar in both the groups.
Conclusion: The use of real time USG during PDT may confer advantage over conventional PDT when using bronchoscopy in terms of decreasing the incidence of minor bleeding but duration of the procedure gets prolonged.
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;71:158–
Gobatto ALN, Besen BAMP, Tierno PFGMM, Mendes PV, Cadamuro F, Joelsons D, et al. Ultrasound-guided percutaneous dilational tracheostomy versus bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients (TRACHUS): a randomized noninferiority controlled trial. Intensive Care Med. 2016;42:342–351. doi: 10.1007/s00134-016-4218-6
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; 91:882–886.
Hartfield A, Bodenham A. Portable ultrasonic scanning of the anterior neck before percutaneous dilatational tracheostomy. Anaesthesia. 1999;54:660–663.
Tremblay LN, Scales DC. Ultrasound-guided tracheostomy--not for the many, but perhaps the few... or the one. Crit Care. 2011; 15:147–148. doi: 10.1186/cc10106
Yavuz A, Yilmaz M, Goya C, Alimoglu E, Kabaalioglu A. Advantages of US in percutaneous dilatational tracheostomy: randomized controlled trial and review of the literature. Radiology. 2014;273:927–936. doi: 10.1148/radiol.14140088
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;18:514–524. doi: 10.1186/s13054-014-0514-0