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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