Ault Mark J, Ault Brian, Ng Philip K
Division of General Internal Medicine, Cedars-Sinai Medical Center and University of California Los Angeles School of Medicine, CA, USA.
J Intensive Care Med. 2003 Jul-Aug;18(4):222-6. doi: 10.1177/0885066603254108.
The study objective of this article was to evaluate percutaneous dilatational tracheostomy (PDT) for emergent airway access. This is a case series of 9 patients who presented over a 58-month period. All patients were in severe respiratory difficulty where intubation by conventional means was unsuccessful. All 9 patients were successfully intubated using PDT technique. No technical complications were noted, specifically bleeding, extratracheal placement, or prolonged procedure time. Six patients ultimately died, 2 from anoxic encephalopathy due to failed resuscitation and 4 from comorbid illness. Three patients ultimately survived to hospital discharge. The authors conclude that PDT can effectively establish a surgical airway in an emergent setting. The major advantage of this technique is the ability to gain and maintain competence in an elective, controlled environment. The authors believe that PDT may play a role in the management of the emergent surgical airway.
本文的研究目的是评估经皮扩张气管切开术（PDT）用于紧急气道建立的情况。这是一个包含9例患者的病例系列，这些患者在58个月的时间里就诊。所有患者均存在严重呼吸困难，常规插管方法未能成功。所有9例患者均使用PDT技术成功插管。未观察到技术并发症，特别是出血、气管外放置或手术时间延长。6例患者最终死亡，2例因复苏失败死于缺氧性脑病，4例死于合并症。3例患者最终存活至出院。作者得出结论，PDT可在紧急情况下有效建立外科气道。该技术的主要优点是能够在选择性、可控环境中获得并保持操作能力。作者认为PDT可能在紧急外科气道管理中发挥作用。
