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Comparative Study Clinical Trial
PERCUTANEOUS DILATATIONAL TRACHEOSTOMY WITH A DOUBLE LUMEN ENDOTRACHEALTUBE: A COMPARISON OF FEASIBILITY, GAS-EXCHANGE AND AIRWAY PRESSURES.
- Maria Vargas, Paolo Pelosi, Gaetano Tessitore, Fulvio Aloj, Iole Brunetti, Enrico Arditi, Dorino Salami, Robert M Kacmarek, and Giuseppe Servillo.
- Chest. 2015 May 1;147(5):1267-74.
ObjectiveGas exchange and airway pressures are markedly altered during percutaneous dilatational tracheostomy (PDT). A double-lumen endotracheal tube (DLET) has been developed for better airway management during PDT. The current study prospectively evaluated the in vivo feasibility, gas exchange, and airway pressures during PDT with DLET compared with a conventional endotracheal tube (ETT).MethodsAccording to eligibility criteria, patients were divided into a case group (those receiving PDT with DLET) and a control group (those receiving PDT with a conventional ETT). The Ciaglia single-dilator technique was used for PDT in both groups. The primary end point of this study was the feasibility of tracheostomy with DLET. The secondary end points were a comparison of gas exchange, airway pressures, minute volume, and tidal volume before, during, and after PDT performed with DLET and conventional ETT.ResultsTen patients meeting the inclusion criteria were assigned to each group. PDTs were performed without difficulties in nine patients in the DLET group and 10 patients in the conventional ETT group. During PDT, gas exchange, airway pressures, and minute ventilation remained more stable in the DLET group and were significantly different from those in the conventional ETT group.ConclusionsPDT with DLET can be performed safely without difficulties limiting the technique. Furthermore, during PDT, the use of the DLET resulted in more stable gas exchange, airway pressures, and ventilation than PDT with a conventional ETT.Trial RegistryClinicalTrials.gov; No.: NCT01691222; URL: www.clinicaltrials.gov.
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