Related Experiment Video
Updated: Apr 22, 2026
Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Comparison between ultrasound- and bronchoscopy-guided percutaneous dilational tracheostomy in critically ill
André Luiz Nunes Gobatto1, Bruno Adler Maccagnan Pinheiro Besen2, Paulo Fernando Guimarães Morando Marzocchi Tierno3
1Medical Intensive Care Unit, Emergency Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Surgical Intensive Care Unit, Anesthesiology Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Introduction:
Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopic guidance. Recently, ultrasound (US) has emerged as a new safety adjunct tool to increase the efficacy of PDT. However, the available data are limited to case series without any control group. Hence, a retrospective cohort study was designed to evaluate the efficacy of US-guided PDT compared with bronchoscopy-guided PDT.
Methods:
All patients who were submitted to PDT after the standardization of US-guided PDT technique in our institution were analyzed. Demographic and procedure-related variables, complications, and clinical outcomes were collected and compared in patients undergoing US- or bronchoscopy-guided PDT.
Results:
Sixty patients who had been submitted to PDT were studied, including 11 under bronchoscopy guidance and 49 under US guidance. No surgical conversion was necessary in any of the procedures, and bronchoscopy assistance was only required in 1 case in the US group. The procedure length was shorter in the US group than in the bronchoscopy group (12 vs 15 minutes, P = .028). None of the patients had any major complications. The minor complication rates were not significantly different between the groups, nor was the probability of breathing without assistance within 28 days, intensive care unit length of stay, or hospital mortality.
Conclusion:
Ultrasound-guided PDT is effective, safe, and associated with similar complication rates and clinical outcomes compared with bronchoscopy-guided PDT.
