Related Experiment Video
Updated: Jun 7, 2026
04:43
Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
Published on: March 15, 2024
Retrosternal percutaneous tracheostomy: an approach for predictably impossible classic tracheostomy
Philippe Biderman1, Avi A Weinbroum, Yael Rafaeli
1Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100, Israel.
Critical Care Research and Practice
|October 29, 2010
Summary
Percutaneous retrosternal tracheostomy offers a safe alternative for patients with difficult anatomy, achieving outcomes comparable to standard tracheostomy. This bedside technique requires careful execution to prevent vascular complications.
Area of Science:
- Intensive Care Medicine
- Surgical Innovation
- Anesthesiology
Background:
- Standard tracheostomy is often inapplicable in patients with specific anatomical challenges, including low larynx position, cervical spine deformation, morbid obesity, or neck tumors.
- These conditions necessitate alternative surgical approaches to secure airway access.
Purpose of the Study:
- To report the outcomes of a retrosternal approach for percutaneous tracheostomy in patients where the classic technique is contraindicated.
- To evaluate the safety and efficacy of this modified technique.
Main Methods:
- A retrosternal approach was employed for percutaneous tracheostomy in 20 patients.
- Preoperative neck computerized tomography (CT) was used to delineate anatomy.
- A small suprasternal incision and retrosternal dissection facilitated tracheal catheterization at the second ring.
Main Results:
- The percutaneous retrosternal tracheostomy procedure was successfully performed.
- Immediate and late outcomes (≥6 months follow-up) were comparable to standard tracheostomy.
- The technique is applicable at the bedside.
Conclusions:
- Percutaneous retrosternal tracheostomy is a safe and effective alternative for patients with abnormal tracheal positioning or neck constitution.
- While generally safe, the procedure demands meticulous technique to mitigate risks of vascular complications.
Related Concept Videos
01:16Tracheostomy Care I: Pre-procedural Steps
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
01:28Tracheostomy: Procedure and Tubes
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:26Tracheostomy Suctioning I: Pre-Procedural Steps
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
01:21Tracheostomy Decannulation
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...