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Observational Study
. 2021 Feb 15;21(1):51.
doi: 10.1186/s12871-021-01264-2.

Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation

Andreas Nowak  1 , Eckart Klemm  2 , Caroline Michaelsen  2 , Taras I Usichenko  3   4 , Sven Koscielny  5
Affiliations
Observational Study

Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation

Andreas Nowak et al. BMC Anesthesiol. .

Abstract

Background: The rigid tracheotomy endoscope (TED) was recently introduced to improve the fiberoptic technique during percutaneous dilatational tracheotomy (PDT) in critically ill patients. The aim was to evaluate the long-term complications of PDT using TED equipment in a prospective multicenter investigation.

Methods: One hundred eighty adult patients underwent PDT using TED in four German hospitals. Patients who were alive or their guardians were contacted via telephone and interviewed using a structured questionnaire 6 months following the tracheostomy procedure. Patients with airway complaints were invited for outpatient clinical ENT examination. The incidence of adverse events related to PDT was registered.

Results: Of 180 patients who received tracheostomy, 137 (76.1%) were alive at the time of follow-up. None of the 43 lethal events was related to the PDT. Fifty-three (38.7%) patients were available for follow-up examination, whereas 14 (10.2%) were able to visit ENT physicians. Two (3.8%) out of 53 patients developed tracheocutaneous fistula with required surgical closure of tracheostoma. Dyspnea (7.5%), hoarseness (5.7%), stridor and swallowing difficulties (both with 3.8%) were the most common complaints. Tracheal stenosis was confirmed in 1 patient (1.88% [95% CI: 0.33; 9.93]).

Conclusion: The use of TED for PDT in the clinical setting is safe regarding adverse events at 6-month follow-up. The incidence of tracheal stenosis after PDT with TED is comparable with that of flexible bronchoscopy; however, its role for PDT at the intensive care unit should be clarified in further investigations.

Keywords: Late complications; Percutaneous dilatational tracheotomy; Rigid endoscopy; Tracheal stenosis; Tracheotomy.

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Conflict of interest statement

None. The authors have no potential financial or academic conflicts of interest to disclose. All authors declare no support from or financial relationships with any organization that might have an interest in the submitted work.

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Enrollment flowchart
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References

    1. Vargas M, Sutherasan Y, Antonelli M, Brunetti I, Corcione A, Laffey JG, et al. Tracheostomy procedures in the intensive care unit: an international survey. Crit Care. 2015;19:291. doi: 10.1186/s13054-015-1013-7. - DOI - PMC - PubMed
    1. Klemm E, Nowak A, editors. Tracheotomy and Airway: A Practical Guide. 1st ed. Springer International; 2020.
    1. Schrom T, Grode-Trübenbach J, Diederich L, Bloching M. Late complications after tracheotomy in the nursing home. Laryngorhinootologie. 2020;99:101–105. doi: 10.1055/a-1058-0440. - DOI - PubMed
    1. Klemm E, Nowak AK. Tracheotomy-related deaths. Dtsch Arztebl Int. 2017;114:273–279. - PMC - PubMed
    1. Karagiannidis C, Merten ML, Heunks L, Strassmann SE, Schäfer S, Magnet F, Windisch W. Respiratory acidosis during bronchoscopy-guided percutaneous dilatational tracheostomy: impact of ventilator settings and endotracheal tube size. BMC Anesthesiol. 2019;19:147. doi: 10.1186/s12871-019-0824-5. - DOI - PMC - PubMed

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