Decision-making algorithm for TS in the ICU
© Marullo et al.; licensee BioMed Central Ltd. 2015
Published: 16 March 2015
Nowadays more percutaneous dilatational tracheostomy (PDT) methods are in use, but there is no ideal risk-free technique. We have outlined a decisional algorithm to choose the most appropriate technique in each case to reduce the incidence of complications.
A retrospective review was performed using data from the last 14 years. Two hundred patients were selected. Patients were divided into two groups: one including the first 100 PDTs treated without the algorithm (nA-group) and the other including the last 100 patients treated with the algorithm (A-group). Valuation of clinical and anatomical features of the patients, neck ultrasound and fibrobronchoscopy came before the procedure . The algorithm was formulated by our experience with PDT techniques, comparing the specific characteristics of each one with the physiopathological characteristics of each patient.
In our experience the application of the proposed algorithm may reduce the incidence of complications related to PDT in the ICU. However, a randomized controlled multicenter study would be necessary in order to confirm the efficiency and validity of the proposed algorithm.
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