Ultrasound-guided Versus Landmark-guided Percutaneous Dilational Tracheostomy in Pediatric Patients
Study Details
Study Description
Brief Summary
Percutaneous dilatational tracheostomy is one of the most common procedures performed in pediatric intensive care units. We aimed to compare traditional landmark-guided percutaneous dilatational tracheostomy (PDT) and ultrasound-guided percutaneous dilatational tracheostomy in pediatric patients in terms of location, duration, and potential complications related to the procedure.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Tracheostomy, one of the most common procedures performed in intensive care units (ICU), refers to creating a stoma in the anterior wall of the trachea to maintain airway security. Tracheostomy can be formed via a surgical or percutaneous dilatational technique (1). The surgical technique requires the transportation of the patient to the operating theatre, while the percutaneous dilatational technique can be performed in the ICU. Thus, ICU practitioners commonly prefer the percutaneous dilatational technique.
Percutaneous dilatational tracheostomy can be performed via three approaches: landmark, ultrasound (USG), or bronchoscopy guided. Although landmark-guided PTD is a practical approach, there are growing concerns regarding the location of the second and third tracheal rings and injuries to vascular structures and the thyroid gland. USG may be helpful to establish the anatomy of the airway and the vascular and glandular structure of the area.
We aimed to compare traditional landmark-guided percutaneous dilatational tracheostomy and USG-guided percutaneous dilatational tracheostomy in pediatric patients in terms of location, duration, and potential complications related to the procedure.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Landmark-guided percutaneous dilatational tracheostomy All patients will be enrolled two times. First, an experienced anesthesiologist will examine the neck anatomy and mark the second or third tracheal ring using the traditional landmark-guided technique, and the duration will be recorded. Then, the same anesthesiologist will examine the neck anatomy and mark the second or third tracheal ring using the ultrasound (USG)-guided approach, and the duration will be recorded. The distance between these two aforementioned markings will be measured and recorded. The first marking determined by the landmark method will be looked at with USG and where it corresponds anatomically will be recorded. Also, the vascular and glandular structures of the area and potential complications will be noted. |
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| Ultrasound-guided percutaneous dilatational tracheostomy All patients will be enrolled two times. First, an experienced anesthesiologist will examine the neck anatomy and mark the second or third tracheal ring using the traditional landmark-guided technique, and the duration will be recorded. Then, the same anesthesiologist will examine the neck anatomy and mark the second or third tracheal ring using the ultrasound (USG)-guided approach, and the duration will be recorded. The distance between these two aforementioned markings will be measured and recorded. The first marking determined by the landmark method will be looked at with USG and where it corresponds anatomically will be recorded. Also, the vascular and glandular structures of the area and potential complications will be noted. |
Device: Ultrasound-guided percutaneous dilatational tracheosyomy
All of the participants will be examined two times. First, the landmark-guided technique will be performed. Then, the ultrasound-guided technique will be performed.
Other Names:
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Outcome Measures
Primary Outcome Measures
- Anatomical accuracy of the entry site for percutaneous dilatational tracheostomy [20 minutes]
Identification of the second and third tracheal ring
Secondary Outcome Measures
- Detection of potential complications of the airway entry point determined by the traditional method [20 minutes]
Proximity of the airway entry point determined by the traditional method to vascular and glandular structures
- The time taken by the landmark-guided and ultrasound-guided techniques [20 minutes]
Time taken to determine the airway entry point with landmark-guided and ultrasound-guided techniques
Eligibility Criteria
Criteria
Inclusion Criteria:
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healthy pediatric patients
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between 5 and 13 years old
Exclusion Criteria:
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neck anomalies
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syndromic patients
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Aksaray University | Aksaray | Turkey | 68640 |
Sponsors and Collaborators
- Aksaray University
Investigators
- Principal Investigator: Cengizhan Kilicaslan, MD, Pediatrician
Study Documents (Full-Text)
None provided.More Information
Publications
- 34-SBKAEK-2023-05-05