Other Tracheostomy Complications, Tracheostomy Complications, Tracheostomy Hemorrhage
Conditions
Keywords
percutaneous tracheostomy, ultrasonography, echography, critical care
Brief summary
The purpose of this study is to determine the feasibility and the safety of ultrasound guided percutaneous dilatational tracheostomy.
Detailed description
Percutaneous tracheostomy is commonly performed in critical care units when ventilatory weaning fails or when prolonged mechanical ventilation is required. Numerous complications have been described since the widespread use of Percutaneous Tracheostomy (PCT). Bronchoscopy-guided percutaneous tracheostomy was developed in this context. However, bronchoscopy cannot identify vascular structures and the thyroid gland in the neck, and therefore cannot prevent complications related to organ lesions in the neck. Several studies have demonstrated the value of ultrasound guidance in the neck before performing PCT. No studies have demonstrated the feasibility and the safety of ultrasound guidance for PCT. Ultrasound could improve the understanding of neck anatomy, prevents vascular puncture, and helps guide insertion of the tracheostomy tube.
Interventions
DEVICEUltrasonography (EnVisor Philips Medical Systems)
Percutaneous tracheostomy is performed using the dilatational method with ultrasonography guidance;
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients hospitalized in ICU in whom percutaneous tracheostomy is indicated, * patients aged \> 18 years old,
Exclusion criteria
* age less than 18 years, * clotting disorder, * infection at the puncture site, * emergency tracheostomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Procedure related complications | At the end of the procedure, then participants will be followed for the duration of hospital stay, an expected average of 6 weeks | Complications are: paratracheal insertion, injuries to blood vessels in the neck, oesophageal injury, accidental decannulation, malposition of the tracheostomy tube, tracheal cuff puncture, multiple punctures (more than 3), surgical conversion and percutaneous tracheostomy failure, bleeding (compressible, incompressible, requiring administration of labile blood products), pneumothorax, pneumomediastinum, tracheostomy puncture site infection, surgical conversion, subglottic stenosis, fracture of a tracheal cartilage, granuloma. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Procedure time | The time will be calculated at the end of the procedure; an average of 30 minutes | The total time consisted of a first phase of ulstrasound examination of the cervical region and an implementation phase under ultrasound of percutaneous tracheostomy. |
Countries
France
Outcome results
None listed