Which Guidance Method during Tracheotomy Procedure in Patients with Short Neck in the ICU:A Prospective Randomized Study

Abstract

Abstract Purpose: Utilization of fiber optic video bronchoscope (F) alone vs. in combination with ultrasound (U + F) during tracheotomy procedures for patients with remarkable short necks. Materials and methods: Nineteen patients with short neck who required tracheotomy were enrolled to study. Tracheotomies were performed with Grigg’s technique. There was 9 patient in U + F group and 10 in F group. We gathered ICU admission diagnosis, demographic variables, guidance method (U + F or F), thyromental, sternomental and cricosternal distances, neck circumference, neck extension range, procedure duration and complications. Results: Mean thyromental distance, sternomental distance, neck extension range and neck circumference was similar between groups. There was no major complication in both groups. Minor bleeding occurred in 1 patient in-group U + F and 2 in group F. One of the patients in U + F group had an aberrant enlarged venous anomaly over tracheal rings and he underwent surgical tracheotomy, therefore he was excluded from this study. Duration of the procedures was 7, 4 min and 7 min in U + F and F group respectively. Conclusion: Using ultrasound and fiber optic bronchoscope together enhance the safety of the tracheotomy procedure and should be considered in patients with short necks who display limited extension.