Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation
Abstract Background The rigid tracheotomy endoscope (TED) was recently introduced to improve the fiberoptic technique during percutaneous dilatational tracheotomy (PDT) in critically ill patients. The aim was to evaluate the long-term complications of PDT using TED equipment in a prospective multice...
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doaj-1d34de38097346b29220a86d86c591c72021-02-21T12:29:02ZengBMCBMC Anesthesiology1471-22532021-02-012111710.1186/s12871-021-01264-2Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigationAndreas Nowak0Eckart Klemm1Caroline Michaelsen2Taras I. Usichenko3Sven Koscielny4Head of the Department of Anesthesiolgy & Intensive Care Medicine, Emergency Medicine & Pain Management, Dresden Municipal Hospital - Academic Teaching Hospital of the Dresden University of TechnologyDepartment of Otorhinolaryngology, Head and Neck Surgery, Plastic Surgery, Dresden Municipal Hospital - Academic Teaching Hospital of the Dresden University of TechnologyDepartment of Otorhinolaryngology, Head and Neck Surgery, Plastic Surgery, Dresden Municipal Hospital - Academic Teaching Hospital of the Dresden University of TechnologyDepartment of Anesthesiology, Intensive Care Medicine, Emergency Medicine, Pain Medicine, University Medicine of GreifswaldDepartment of Otolaryngology and Institute of Phoniatry and Pedaudiology, Jena University HospitalAbstract Background The rigid tracheotomy endoscope (TED) was recently introduced to improve the fiberoptic technique during percutaneous dilatational tracheotomy (PDT) in critically ill patients. The aim was to evaluate the long-term complications of PDT using TED equipment in a prospective multicenter investigation. Methods One hundred eighty adult patients underwent PDT using TED in four German hospitals. Patients who were alive or their guardians were contacted via telephone and interviewed using a structured questionnaire 6 months following the tracheostomy procedure. Patients with airway complaints were invited for outpatient clinical ENT examination. The incidence of adverse events related to PDT was registered. Results Of 180 patients who received tracheostomy, 137 (76.1%) were alive at the time of follow-up. None of the 43 lethal events was related to the PDT. Fifty-three (38.7%) patients were available for follow-up examination, whereas 14 (10.2%) were able to visit ENT physicians. Two (3.8%) out of 53 patients developed tracheocutaneous fistula with required surgical closure of tracheostoma. Dyspnea (7.5%), hoarseness (5.7%), stridor and swallowing difficulties (both with 3.8%) were the most common complaints. Tracheal stenosis was confirmed in 1 patient (1.88% [95% CI: 0.33; 9.93]). Conclusion The use of TED for PDT in the clinical setting is safe regarding adverse events at 6-month follow-up. The incidence of tracheal stenosis after PDT with TED is comparable with that of flexible bronchoscopy; however, its role for PDT at the intensive care unit should be clarified in further investigations.https://doi.org/10.1186/s12871-021-01264-2TracheotomyPercutaneous dilatational tracheotomyRigid endoscopyLate complicationsTracheal stenosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andreas Nowak Eckart Klemm Caroline Michaelsen Taras I. Usichenko Sven Koscielny |
spellingShingle |
Andreas Nowak Eckart Klemm Caroline Michaelsen Taras I. Usichenko Sven Koscielny Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation BMC Anesthesiology Tracheotomy Percutaneous dilatational tracheotomy Rigid endoscopy Late complications Tracheal stenosis |
author_facet |
Andreas Nowak Eckart Klemm Caroline Michaelsen Taras I. Usichenko Sven Koscielny |
author_sort |
Andreas Nowak |
title |
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation |
title_short |
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation |
title_full |
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation |
title_fullStr |
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation |
title_full_unstemmed |
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation |
title_sort |
safety of percutaneous dilatational tracheotomy (pdt) with the rigid tracheotomy endoscope (ted): a 6-month follow-up multicenter investigation |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2021-02-01 |
description |
Abstract Background The rigid tracheotomy endoscope (TED) was recently introduced to improve the fiberoptic technique during percutaneous dilatational tracheotomy (PDT) in critically ill patients. The aim was to evaluate the long-term complications of PDT using TED equipment in a prospective multicenter investigation. Methods One hundred eighty adult patients underwent PDT using TED in four German hospitals. Patients who were alive or their guardians were contacted via telephone and interviewed using a structured questionnaire 6 months following the tracheostomy procedure. Patients with airway complaints were invited for outpatient clinical ENT examination. The incidence of adverse events related to PDT was registered. Results Of 180 patients who received tracheostomy, 137 (76.1%) were alive at the time of follow-up. None of the 43 lethal events was related to the PDT. Fifty-three (38.7%) patients were available for follow-up examination, whereas 14 (10.2%) were able to visit ENT physicians. Two (3.8%) out of 53 patients developed tracheocutaneous fistula with required surgical closure of tracheostoma. Dyspnea (7.5%), hoarseness (5.7%), stridor and swallowing difficulties (both with 3.8%) were the most common complaints. Tracheal stenosis was confirmed in 1 patient (1.88% [95% CI: 0.33; 9.93]). Conclusion The use of TED for PDT in the clinical setting is safe regarding adverse events at 6-month follow-up. The incidence of tracheal stenosis after PDT with TED is comparable with that of flexible bronchoscopy; however, its role for PDT at the intensive care unit should be clarified in further investigations. |
topic |
Tracheotomy Percutaneous dilatational tracheotomy Rigid endoscopy Late complications Tracheal stenosis |
url |
https://doi.org/10.1186/s12871-021-01264-2 |
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