Assessment of the percutaneous dilatational tracheostomy technique in experimental manikins and canine cadavers.

Abstract

Objective: To evaluate procedure time, ease of placement, and complication rates of percutaneous dilatational tracheostomy (PDT) compared to surgical tracheostomy (ST) in canine cadavers.

Design: Randomized crossover experimental manikin and cadaver study involving 6 novice veterinary students.

Setting: University teaching hospital.

Animals: Canine tracheostomy training manikin, 24 canine cadavers.

Interventions: None.

Measurements and main results: For training, each student performed 10 PDT and 10 ST procedures on a training manikin, followed by 2 PDT and 2 ST procedures on a canine cadaver. After each training procedure, feedback from bronchoscopy and observers was provided. Final PDT and ST tube placements using new equipment were performed in unused cadavers. Placements were timed, ease of placement was scored using visual analog scales (VAS, 0-10 cm), and complications were assessed by two independent observers using ordinal scales (0-3). Cadaver tracheas were explanted postprocedure to evaluate anatomical damage scores (0-3). Procedure time and VAS scores for PDT and ST procedures were analyzed using mixed-effects linear models, accounting for student, technique, and procedure number with post hoc pairwise comparisons. Data are presented as median (range). For the final cadaver placement, there were no significant differences in placement time (300 seconds [230-1020] vs 188 seconds [116-414], P = 0.210), ease of placement (3.8 cm [2.1-5.7] vs 1.9 cm [0-4.7], P = 0.132), anatomical damage score (1 [0-2] vs 0 [0-1], P = 0.063), or equipment complications score (0 [0-1] vs 0 [0-0], P = 1.000) between PDT and ST, respectively.

Conclusions: These data suggest that PDT can be performed as quickly, as easily, and as safely as ST in a canine cadaver by novice veterinary students following manikin training. Additional studies will be required to determine if these findings can be translated into veterinary clinical practice.