• André Luiz Nunes Gobatto, Bruno Adler Maccagnan Pinheiro Besen, Paulo Fernando Guimarães Morando Marzocchi Tierno, Pedro Vitale Mendes, Filipe Cadamuro, Daniel Joelsons, Livia Melro, Marcelo Park, and Luiz Marcelo Sá Malbouisson.
• Medical 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. Electronic address: andregobatto@gmail.com.
• J Crit Care. 2015 Feb 1;30(1):220.e13-7.

IntroductionPercutaneous 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.MethodsAll 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.ResultsSixty 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.ConclusionUltrasound-guided PDT is effective, safe, and associated with similar complication rates and clinical outcomes compared with bronchoscopy-guided PDT.Copyright © 2014 Elsevier Inc. All rights reserved.

21 keywords...

hide…