Skip to main content

Table 1 Summary of the best available evidence supporting the use of ultrasound-percutaneous dilatational tracheostomy

From: Use of ultrasound guidance to improve the safety of percutaneous dilatational tracheostomy: a literature review

Type of US guidance used Author Study design Number of patients Outcome Complications
Pre-procedural Bonde et al. [39] Prospective Observational No control group 28 (excluded patients had severe coagulopathy or were morbidly obese) Changed puncture location in nine patients (32.1 %); elective vessel ligation in three patients (10.7 %) Minor bleeding in two patients (7.1 %)
Kollig et al. [43] Prospective Observational No control group 72 Changed puncture location in 17 patients (23.6 %); changed to surgical tracheostomy in one patient (1.3 %) Minor bleeding in one patient (1.3 %)
Real-time Sustić et al. [34] Retrospective Control group was landmark-guided. 26 Cranial misplacement: 0 % versus 33 % (P <0.05) Tracheal ring fracture: 36 % versus 43 % (not significant)
Rajajee et al. [46] Prospective Feasibility No control group 13 All PDTs were successful. Appropriate positioning of puncture was confirmed on bronchoscopy. No significant complications were reported.
Pre-procedural US and real-time Guinot et al. [24] Prospective Observational No control group 50 (obese patients and patients with severe coagulopathy were excluded) All PDTs were successful. Puncture location was changed in 25 patients (50 %). Minor bleeding in three patients (6 %); wound infection in one patient (2 %)
Real-time US guidance Rudas et al. [47] Randomised controlled trial 50 First-pass success rates were 87 % in the US group and 58 % in the landmark group (P = 0.028). The decrease in procedural complications was not statistically significant: 22 % in the US group versus 37 % in the landmark group (P = 0.24).
Pre- and post-procedural US Yavuz et al. [48] Randomised controlled trial 341 The puncture sites designated at the physical examination were reconsidered in 23.8 % of 164 cases. The mean procedure times for the US group and the controls were 24.09 minutes ± 8.05 and 18.62 minutes ± 6.34, respectively (P = .001). The perioperative complication rates were slightly lower in the US group (7.8 %) than in the control group (15.0 %); not statistically significant (P = 0.054).
  1. All studies were performed in intensive care units. PDT, percutaneous dilatational tracheostomy; US, ultrasound