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Visual-Guided Transillumination Method for Accurate Percutaneous Tracheal Tube Placement
Diane C McLaughlin1,2, Michael P Schaller3, Julian Bösel4,5
1Lyerly Neurosurgery, Baptist Medical Group, Jacksonville, FL.
Critical Care Explorations
|March 27, 2025
Summary
The novel Illuminated Tracheal Alignment Guide (iTAG) device significantly reduces early complications during percutaneous tracheostomy (PT), improving patient safety and expanding procedural candidacy.
Area of Science:
- Medical Devices
- Surgical Procedures
- Critical Care Medicine
Background:
- Percutaneous tracheostomy (PT) carries risks like malpositioning and bleeding.
- A novel Illuminated Tracheal Alignment Guide (iTAG) device aims to improve PT safety.
Purpose of the Study:
- To evaluate the feasibility, ease of use, and safety of the iTAG device for bedside percutaneous tracheostomy.
Main Methods:
- An interventional pilot study involving 30 patients in a neurocritical care unit.
- The iTAG device, featuring a laser light and needle guide, was used with standard PT equipment.
- Data collected included demographics, procedure details, and early complications, compared to historical standard tracheostomy (ST) data.
Main Results:
- The iTAG device was used safely in all 30 patients.
- Significantly fewer early complications, including hemorrhage, were observed compared to the ST group.
- No tracheal ring fractures, posterior wall injuries, or pneumothoraces occurred with iTAG.
Conclusions:
- The iTAG device enhances PT safety and efficacy through precise visualization and controlled needle depth.
- It reduces early complications and may expand patient eligibility for PT.
- Further research, including RCTs, is recommended to establish iTAG as a standard of care.
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