Respiratory Depression, Respiratory Failure
Conditions
Keywords
tracheostomy，fascia，force gauge
Brief summary
Percutaneous dilatational tracheostomy (PDT), especially single-step dilatational tracheostomy (sd-PDT), is now frequently preferred to surgical tracheostomy. Occasionally, it needs a second dilation maneuver .Dissection of the deep cervical fascia during PDT, known as reformative PDT (re-PDT), may facilitate the procedure. This study was designed to compare re-PDT with sd-PDT in ICU patients
Detailed description
Percutaneous dilatational tracheostomy (PDT) is a popular airway management technique in the intensive care unit (ICU).Occasionally the first dilation may be challenging when using Ciaglia and colleagues' method, and a second dilation may be needed to insert the tracheostomy tube. In these circumstances, potentially life-threatening complications, such as hemorrhage and hypoxia, may arise. The investigators found the reasons for difficulty in achieving smooth dilation of the stoma.The investigators compared the traditional method with the improved method.
Interventions
PROCEDUREreformative dilation technique
reformative dilation technique was used when operating tracheostomy
Sponsors
The First Affiliated Hospital with Nanjing Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
44 Years to 89 Years
Healthy volunteers
No
Inclusion criteria
* age ≥18 years; * requirement for long-term mechanical ventilation; * failure of weaning from mechanical ventilation.
Exclusion criteria
* age \<18 years; * pre-existing infection at the tracheostomy site; * pre-existing malignancy at the tracheostomy site; * difficulty in identifying the anatomic landmarks; * unstable cervical spine fracture; * international normalized ratio (INR) \>2; * platelet count \<50 000 mm3.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Force(newton) | Intraoperative (Force was measured the exact moment when investigators insert the'J' guidewire) | Force refers to the force needed to dilate the airway and measured by force gauge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time(seconds) | Time was measured from tracheal puncture to tracheal tube placement, 180 seconds maxime | Time refers to the time needed to finish the whole step from tracheal puncture to tracheal tube placement |
Countries
China
Outcome results
None listed