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Published on: September 28, 2022
Evaluation of a modified percutaneous tracheostomy technique without bronchoscopic guidance
Haim Paran1, Gabriel Butnaru, Ilana Hass
1Department of Surgery "A", Meir Hospital, Sapir Medical Center, Kfar Sava, 44281, Israel. Paran620@green.co.il
Chest
|September 15, 2004
Summary
A modified percutaneous tracheostomy technique using finger guidance instead of routine bronchoscopy is simple and safe. This approach reduces complications and costs for elective procedures.
Area of Science:
- Medical procedures
- Surgical techniques
- Airway management
Background:
- Percutaneous tracheostomy complications often stem from cannulation failure or surrounding structure injury.
- Traditional bronchoscopic assistance can impede ventilation and is cumbersome.
- A modified technique involves blunt dissection and finger guidance, negating routine bronchoscope use.
Purpose of the Study:
- To evaluate a modified percutaneous tracheostomy technique.
- To assess the safety and efficacy of a finger-guided approach without routine bronchoscopy.
Main Methods:
- An observational clinical study prospectively evaluated the modified technique over 30 months.
- Elective tracheostomy patients underwent the procedure using two commercial kits.
- Data collected included operative technique, complications, failure rate, and airway loss.
Main Results:
- Sixty-one procedures were attempted bedside; three were deferred due to anatomical issues or inadequate equipment.
- One patient experienced wound bleeding requiring revision; no other significant procedure-related complications occurred.
- Early tube dislodgement was reported in three patients, but its relation to the technique is uncertain.
Conclusions:
- The modified percutaneous tracheostomy technique is simple, safe, and effective for physicians with surgical training.
- It offers reduced morbidity, cost savings, and decreased operating room burden.
- This finger-guided method eliminates the need for routine bronchoscopy.
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