Öner Özlem, Dağlı Sinem, Gürkok Mehmet Çağatay, Öztürk Ejder Kamil, Ergan Begüm, Hancı Volkan, Gökmen Ali Necati, Yaka Erdem
Faculty of Medicine, Department of Anesthesiology and Reanimation, Subaffiliationision of Critical Care Medicine, Dokuz Eylül University, İzmir, Turkey.
Department of Pulmonary, Yalova Training and Research Hospital, Subaffiliationision of Critical Care Medicine, Yalova, Turkey.
BMC Anesthesiol. 2025 Mar 31;25(1):142. doi: 10.1186/s12871-025-03022-0.
The benefit of fiberoptic bronchoscopy (FOB) guidance during percutaneous dilatational tracheostomy (PDT) remains unclear. We aimed to compare PDT performed with and without FOB guidance in terms of procedure duration, number of attempts, and perioperative complications.
A total of 103 patients were divided into two groups, and the PDT procedure was performed either with or without FOB guidance. The primary outcome of our study was the duration of the tracheostomy procedure (PDT procedure time) and the number of attempts. The secondary outcome was the major/minor complications that might develop during and after tracheostomy.
The mean PDT procedure time was 8 (4-14) minutes in the FOB (-) group and 7 (3-14) minutes in the FOB (+) group, with no statistically significant difference between them (p = 0.081). The mean number of PDT attempts was the same in both the FOB (-) and FOB (+) groups, 1 (1-3) (p = 0.079). Hypoxemia/desaturation occurred in 1 (2%) patient in the FOB (-) group and in 1 (1.9%) patient in the FOB (+) group (p = 0.748). Cardiac arrhythmia occurred in 2 (3.9%) patients in the FOB (-) group and in 2 (3.8%) patients in the FOB (+) group (p = 0.684). No cases of pneumothorax or pneumomediastinum were observed in either group (p > 0.999).
No difference was found between the two groups in terms of procedure duration, number of attempts, and perioperative complications when performing PDT in the intensive care unit with or without fiberoptic bronchoscopy guidance. PDT can be performed effectively and safely in critically ill patients using a standardized approach by an experienced team, with or without bronchoscopy guidance. However, further investigation and advanced studies are needed to evaluate both methods in more detail.
Retrospectively registered. Clinical trial number was not applicable.
在经皮扩张气管切开术（PDT）期间，纤维支气管镜（FOB）引导的益处仍不明确。我们旨在比较在有和没有FOB引导的情况下进行PDT的手术时间、尝试次数和围手术期并发症。
总共103例患者被分为两组，分别在有或没有FOB引导的情况下进行PDT手术。我们研究的主要结果是气管切开术的持续时间（PDT手术时间）和尝试次数。次要结果是气管切开术期间及之后可能出现的主要/次要并发症。
FOB（-）组的平均PDT手术时间为8（4 - 14）分钟，FOB（+）组为7（3 - 14）分钟，两组之间无统计学显著差异（p = 0.081）。FOB（-）组和FOB（+）组的平均PDT尝试次数相同，均为1（1 - 3）次（p = 0.079）。FOB（-）组有1例（2%）患者发生低氧血症/血氧饱和度下降，FOB（+）组有1例（1.9%）患者发生（p = 0.748）。FOB（-）组有2例（3.9%）患者发生心律失常，FOB（+）组有2例（3.8%）患者发生（p = 0.684）。两组均未观察到气胸或纵隔气肿病例（p > 0.999）。
在重症监护病房进行PDT时，无论有无纤维支气管镜引导，两组在手术持续时间、尝试次数和围手术期并发症方面均未发现差异。经验丰富的团队采用标准化方法，无论有无支气管镜引导，均可在重症患者中有效且安全地进行PDT。然而，需要进一步的调查和深入研究以更详细地评估这两种方法。
回顾性注册。临床试验编号不适用。
