Comparison of Ultrasound- guided Percutaneous dilational Tracheostomy with Landmarks Percutaneous dilational tracheostomy in patients admitted to ICU

Background: Percutaneous dilational Tracheostomy is one of the most commonly used interventions in the ICU. Ultrasound- guided percutaneous dilational tracheostomy is rarely reported in studies. In this study, we compared ultrasound-guided percutaneous dilational tracheostomy with landmarks percutaneous dilational tracheostomy in patients admitted to intensive care unit (ICU) in Urmia. Materials and Methods: In this single-blinded clinical trial study, ۶۰ patients were enrolled. These patients were randomly divided into an intervention group (ultrasound guidance method) and a control group (landmark method). Patients’ demographic characteristics, mean tracheostomy insertion time, mean needle puncture frequency for tracheostomy, frequency of early complications within ۴۸ hours and mortality rate followed by PDT were recorded for all patients. After completing the study, the data was entered into SPSS version ۲۱ and analyzed by Fisher Exact test, Chi-Square test and T- test. P<۰.۰۵ was significant. Results: The mean age of patients in the case and control groups was ۶۲.۵۶±۱۶.۳۲ and ۵۶.۳۰ ± ۱۹.۶۰ years old, respectively. There was a significant difference between patients (case and control group) in mean intubation time, mean duration of mechanical ventilation, mean needle puncture frequency, meantime of PDT insertion, mean ventilation time through tracheostomy (p<۰.۰۵). Moreover, no significant difference was observed between these patients (case and control group) in APACHE II score, however, there was a significant difference between discharged and dead patients in both groups in mean APACHEII scores (P <۰.۰۵). Conclusion: The results of this study showed that using ultrasound- guided percutaneous dilational tracheostomy reduces the frequency of needle punctures.

Keywords:

Percutaneous dilational tracheostomy , Sonography , Landmark , intensive care unit