Can mini-tracheostomy needle be safer for residency training in percutaneous dilatation tracheostomy applications in intensive care unit?

Abstract

Aim The aim of study to evaluate the bedside percutaneous dilatation tracheostomy, performed with Fiberoptic bronchoscopy guided Griggs technique using a mini-tracheostomy needle, by residents in intensive care unit retrospectively. Materials and Methods Percutaneous dilatation tracheostomys performed in 20 intensive care unit patients using a mini-tracheostomy needle. All percutaneous dilatation tracheostomy procedures were performed by a resident who was currently undergoing intensive care unit residency training. Griggs technique was used in all procedures. All complications, the time from needle insertion to the insertion of the tracheostomy cannula was also noted. Results The average age of the patients was 69.8 ± 16.14 years. The mean Acute Physiology and Chronic Health Assessment (APACHE) II score of the patients was 23.05 ± 6.16, Glasgow Coma Scale (GCS) score was 10 ± 3.43, and Sepsis-Related Organ Failure Assessment (SOFA) score was 7.2 ± 2.11. The mean procedure time was 13 ± 1.68 minutes, and the day of tracheostomy application was 6.35 ± 4.59. Twelve (60%) patients were switched to home-type ventilators. Ten (50%) of the patients were transferred to the palliative ward with home-type ventilator. Mortality rate was 20% (4 patients) at 90 days. When patients were evaluated in terms of complications; none of the patients had pneumothorax, subcutaneous emphysema, posterior tracheal wall damage, or tracheoesophageal fistula. Minimal bleeding that required no intervention was observed in only one patient. Conclusion Using Mini-trach® needle in percutaneous dilatation tracheostomys performed via fiberoptic broncoscopy by less experienced residents may be safer to prevent complications.

Keywords

• mini-tracheostomy
• PDT
• residency training
• mini-trach needle

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