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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2009 January-February;75(1-2):21-5
Percutaneous dilatational tracheostomy: a self-drive control technique with video fiberoptic bronchoscopy reduces perioperative complications
Peris A., Linden M., Pellegrini G., Anichini V., Di Filippo A.
Unit of Anesthesia and Intensive Care, Department of Emergency, Careggi Teaching Hospital, Florence, Italy
Background. The aim of this study was to demonstrate that performance of percutaneous dilatational tracheostomy (PDT) associated with a self-drive control technique lowers the incidence of complications.
Methods. A case-control, before-and-after, retrospective study. Place of study: A major teaching hospital in the Department of Emergency, Intensive Care Unit. Patients: we studied 128 patients who underwent fiberoptic-guided PDT over an 18 month period of time. Thirty-nine patients were assisted by conventional fiberoptic bronchoscopy, while 89 video-assisted fiberoptic procedures were performed in which the operator controlled his own actions on a screen. We defined perioperative complications as accidental extubation, perioperative hemorrhage, tracheal ring rupture, lesions of the tracheal wall, and abnormal insertion of the cannula. A Chi-square test, Student’s t-test and U Mann Whitney test were used to compare the incidence of complications and the duration of procedure in the traditional fiberoptic PDT group and in the video-guided group.
Results. Procedure time was significantly shorter in the group with the self-drive control technique. There was also a reduction of the number of perioperative complications.
Conclusion. Fiberoptic bronchoscopy associated with a video system seems effective in reducing the risk of perioperative complications.