Harrer, Dennis Christoph and Mester, Patricia and Lang, Clara-Larissa and Elger, Tanja and Seefeldt, Tobias and Waechter, Lorenz and Doenz, Judith and Doblinger, Nina and Huss, Muriel and Athanasoulas, Georgios and Krauss, Lea U. and Heymer, Johannes and Herr, Wolfgang and Schilling, Tobias and Schmid, Stephan and Mueller, Martina and Pavel, Vlad (2024) Minimally-invasive tracheostomy (MIT): A care bundle for safety improvement in high-risk critically ill patients. JOURNAL OF CLINICAL ANESTHESIA, 99: 111631. ISSN 0952-8180, 1873-4529
Full text not available from this repository. (Request a copy)Abstract
Background: Detailed reports are scarce on minimally-invasive tracheostomy (MIT) techniques for critically ill patients with challenging anatomy or complex coagulopathies. In such high-risk patients, conventional percutaneous dilatational tracheostomy (PDT) may lead to severe complications. Methods: Aiming to broaden the scope of MIT for patients previously excluded due to high risks, we developed a new care bundle (MIT technique), specifically designed for intensive care specialists. Our study examined the outcomes of MIT in 32 high-risk patients treated in an ICU of a University Hospital with specific focus on gastrointestinal and liver diseases. Results: We have modified the conventional PDT technique by incorporating an initial skin incision, blunt dissection, diaphanoscopy-guided probe puncture, and continuous bronchoscopic monitoring. Our care bundle also introduces an anterolateral approach for tracheal entry, a significant advancement for patients with complex neck anatomy or dense vasculature, where an anterolateral trajectory avoids midline blood vessels. This enhanced method has proven to be safer than traditional PDT, with a notable absence of post-procedural hemorrhages, cannula misplacements, or infections. Conclusion: The use of our refined care bundle enabled swift minimally-invasive tracheostomy in high-risk patients without the occurrence of serious complications.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PERCUTANEOUS DILATATIONAL TRACHEOSTOMY; DILATIONAL TRACHEOSTOMY; BRONCHOSCOPY; VEINS; Tracheostomy; Percutaneous dilatational tracheostomy; Critical care; Mechanical ventilation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Jan 2026 08:16 |
| Last Modified: | 20 Jan 2026 08:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64015 |
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