Real-time ultrasound-guided laryngeal mask assisted percutaneous dilatational tracheostomy versus bronchoscopy-guided percutaneous dilatational tracheostomy in critically ill patients: a randomized controlled trial.

IF 2.8 3区医学 Q2 RESPIRATORY SYSTEM

BMC Pulmonary Medicine Pub Date : 2025-04-25 DOI:10.1186/s12890-025-03645-6

Sameh Taha, Jihad Mallat, Mohamed Elsaidi, Ashraf Al-Agami, Ahmed Taha

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引用次数: 0

Abstract

Background: Percutaneous dilatational tracheostomy (PDT) is a common procedure for mechanically ventilated patients in the intensive care unit (ICU). This study compared the real-time ultrasound-guided PDT using a laryngeal mask airway (LMA) with the standard bronchoscopy-guided PDT technique in ICU patients requiring elective tracheostomy.

Methods: This randomized controlled study was conducted at Ain Shams University Hospital's Critical Care Department from December 4th, 2021, to December 3rd, 2022. The study population included 60 critically ill patients admitted to the ICU. Thirty patients were randomly assigned to the real-time ultrasound-guided LMA-assisted group, and 30 patients were randomly assigned to the bronchoscopy-guided technique. The primary study outcome was the procedure time, and the secondary outcomes included procedure-related complications rate and cost-effectiveness.

Results: The real-time ultrasound-guided LMA-assisted group had significantly shorter procedure time (median 17 [IQR: 15-20] min vs. 35 [IQR: 28-39] min, p < 0.001) and lower equipment damage (0% vs. 20%, p = 0.024) during the procedure compared to the bronchoscopy-guided group. Additionally, the cost of tracheostomy was significantly lower in the real-time ultrasound-guided LMA-assisted group (median: 300 vs. 800 USD, p < 0.001). The real-time ultrasound-guided LMA group had a lower major complications rate than the bronchoscopy-guided group (36.7%) vs. 3.3%, p = 0.002).

Conclusions: The study demonstrated that real-time ultrasound-guided LMA-assisted PDT had shorter procedure time, reduced equipment damage, lower costs, and was associated with lower complications when compared to the bronchoscopy-guided technique. These findings suggest that ultrasound guidance can enhance the efficiency and cost-effectiveness of PDT procedures.

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实时超声引导喉罩辅助下经皮扩张性气管切开术与支气管镜引导下经皮扩张性气管切开术：一项随机对照试验。

背景：经皮扩张性气管造口术（PDT）是重症监护病房（ICU）机械通气患者的常见手术。本研究比较了使用喉罩气道（LMA）的实时超声引导PDT与标准支气管镜引导下的PDT技术在ICU患者择期气管切开术中的应用。方法：本随机对照研究于2021年12月4日至2022年12月3日在艾因沙姆斯大学医院重症监护室进行。研究人群包括60名重症监护病房的危重患者。30例患者随机分为实时超声引导lma辅助组，30例患者随机分为支气管镜引导组。主要研究结果是手术时间，次要结果包括手术相关并发症发生率和成本效益。结果：实时超声引导下lma辅助组手术时间明显缩短（中位数17 [IQR: 15-20] min vs. 35 [IQR: 28-39] min）。结论：本研究表明，与支气管镜引导技术相比，实时超声引导下lma辅助PDT手术时间更短，设备损伤更小，成本更低，并发症更少。这些发现表明，超声引导可以提高PDT手术的效率和成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pulmonary Medicine RESPIRATORY SYSTEM-

CiteScore

4.40

自引率

3.20%

发文量

423

审稿时长

6-12 weeks

期刊介绍： BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.