Pre-procedural Ultrasonography for Tracheostomy in Critically Ill Patients: A Prospective Study

Area of Science:

• Critical Care Medicine
• Surgical Procedures
• Medical Imaging

Background:

• Percutaneous dilatational tracheostomy (PDT) is standard for long-term ventilation in critically ill patients.
• Bleeding due to vascular variations is a common early complication of PDT.
• Bedside PDT is preferred, with open tracheostomy as the alternative if unsafe.

Purpose of the Study:

• To assess ultrasound's utility in deciding between bedside PDT and open surgical tracheostomy.
• To evaluate how pre-procedural ultrasound findings influence tracheostomy method selection.

Main Methods:

• Patients were evaluated by critical care and head/neck surgeons.
• Tracheostomy method was initially determined.
• Pre-procedural neck ultrasound was performed, and decisions were re-evaluated based on findings.

Main Results:

• The study included 36 patients.
• Ultrasound examination led to a change in management decisions for 9 patients (25%).

Conclusions:

• Pre-procedural ultrasound can alter management decisions for tracheostomy in critically ill patients.
• Ultrasound provides valuable information for selecting the optimal tracheostomy approach.