Other Tracheostomy Complication Clinical Trial
Official title:
Percutaneous Tracheostomy - Systematic Comparison Among Three Methods: US-guided Tracheostomy, Bronchoscopy Guided Tracheostomy, and Direct Laryngoscopy Tracheostomy.
Percutaneous tracheostomy is routinely performed in most intensive care units in the
world.Several studies have shown that the procedure is safe and economically efficient in
comparison to open surgical operation in the operating room.
In our institution as in a number of institutions in the country, it is acceptable to
perform the operation by placing the tube on a high position near the vocal cords by direct
laryngoscopy and then puncturing the trachea with a needle, by location of the anatomy by
palpation of the neck.
Using technological aids, such as direct sonography and bronchoscopy in real time may
significantly reduce the rate of complications as a result of performing percutaneous
tracheostomy.
So far, no systematic comparison has been made among the three methods.
Percutaneous tracheostomy is routinely performed in most intensive care units in the world
in a number of indications, such as: airway obstruction, need for a long respiratory
support, improvement in respiratory toilet, prophylaxis before head and neck procedures and
cases of severe obstructive sleep apnea.
Several studies have shown that the procedure is safe and economically efficient in
comparison to open surgical operation in the operating room.
In many places around the world it is customary in to perform the operation under the
guidance of a bronchoscope to prevent damage to adjacent structures, high or low position of
the tube, and damage to the posterior wall of the trachea and to approve the final position
of the tube. However, the use of a bronchoscope depends on the availability of the
equipment, knowledge of the operator, temporary occlusion of the trachea and hypercarbia,
increased length of the procedure, and maintenance cost (disinfection, replacement, etc.).
Ultrasound that is performed before percutaneous procedure may be useful in preventing
damage to para tracheal adjacent structures, and preventing high placement of the tube. The
use of duplex sonography with real-time visualization of the needle path is done routinely
in procedures such as central venous catheterization, and may improve the safety and
accuracy of percutaneous tracheostomy without causing airway obstruction or hypercarbia.
Feasibility of the procedure has been reviewed in an article by Rajajee et al .
In our institution as in a number of institutions in the country, it is acceptable to
perform the operation by placing the tube on a high position near the vocal cords by direct
laryngoscopy and then puncturing the trachea with a needle, by location of the anatomy by
palpation of the neck.
So far, no systematic comparison has been made among the three methods.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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N/A | |
| Not yet recruiting |
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N/A |