0
Slide Presentations: Sunday, October 23, 2011 |

Improving Safety of Percutaneous Tracheostomy Using Ultrasound Screening FREE TO VIEW

Adel Bassily-Marcus, MD; Kaare Weber, MD; Leon Boudourakis, MD; Satyanarayana Reddy Mukkera, MD; John Oropello, MD; Anthony Manasia, MD; Roopa Kohli-Seth, MD; Ernest Benjamin, MD
Chest. 2011;140(4_MeetingAbstracts):893A. doi:10.1378/chest.1119805
Text Size: A A A
Published online

Abstract

PURPOSE: To assess the utility of tracheal ultrasound as a screening tool prior to percutaneous dilatational tracheostomy (PDT).

METHODS: Forty four (44) mechanically ventilated patients in a surgical intensive care unit underwent ultrasound screening of the trachea prior to planned PDT using a Sonosite M-Turbo machine. Screening included anatomical analysis of the trachea and the surrounding structures including identification of the cricoid cartilage, second tracheal ring, thyroid isthmus and any vascular anomalies.

RESULTS: Ultrasound analysis identified 12 patients (27%) with significant anatomic variations which prompted cancellation of a percutaneous tracheostomy and conversion to a planned open surgical tracheostomy. These included 5 patients with a high riding innominate artery, 5 with inferiorly displaced cricoid cartilages with the second tracheal ring below the sternal notch, and 2 large thyroid goiters. These findings were not appreciated by surface landmarks. There were 32 patients that subsequently underwent an uncomplicated PDT.

CONCLUSIONS: Ultrasound identified anatomic variations in a significant number of patients not appreciated on physical examination alone.

CLINICAL IMPLICATIONS: Ultrasound screening prior to percutaneous tracheostomy may help to avoid serious complications such as cranial misplaced trachea, bleeding, and tracheoinnominate fistula and provides additional information that may improve the safety of the procedure.

DISCLOSURE: The following authors have nothing to disclose: Adel Bassily-Marcus, Kaare Weber, Leon Boudourakis, Satyanarayana Reddy Mukkera, John Oropello, Anthony Manasia, Roopa Kohli-Seth, Ernest Benjamin

No Product/Research Disclosure Information

10:45 AM - 12:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543