Percutaneous tracheostomy in Intensive care unit (ICU) is performed with the use of flexible fiberoptic bronchoscope inside the conventional single lumen endotracheal tube owned by the patients. This situation may lead to many disadvantages for ventilation and airway protection of critically ill patients during the procedures. The use of double lumen endotracheal tube dedicated to the percutaneous tracheostomies may: 1. improve the ventilation of patients during the procedure, 2. protect the posterior tracheal wall from damage related to the different step of tracheostomies, 3. protect the lungs from blood and secretions coming down from the chosen site of tracheostomy. So the aim of this study is to evaluate the oxygenation, gas exchange, ventilation and complications of percutaneous tracheostomies performed in ICU with a dedicated double lumen endotracheal tube.
Study Type
INTERVENTIONAL
Allocation
NA
Masking
NONE
Enrollment
30
Percutaneous tracheostomy in this study will be performed with the use of a dedicated double-lumen endotracheal tube. The dedicated double-lumen endotracheal tube (Deas S.R.L, Italy) has an upper and a lower lumen. The upper one will be occupied by flexible fiberoptic bronchoscope while the lower one is exclusively dedicated to patient ventilation during the procedure. The lower lumen has a a semi-elliptical cross section. This tube will be placed in the patient airway with a direct laryngoscopy. After this intubation, a percutaneous dilatational tracheostomy will be performed with the standard techniques recognised in the literature.
University of Genoa
Genoa, Italy, Italy
RECRUITINGUniversity of Naples "Federico II"
Naples, Italy, Italy
RECRUITINGchange in gas-exchange
The investigator will perform an arterial blood gas to evaluate PaO2/FiO2 ratio
Time frame: at the baseline and the end of the procedure (average time expected for the procedure is 30 minutes)
change in arterial carbon dioxide
the investigator will perform an arterial blood gas to evaluate PaCO2
Time frame: at the baseline and at the end of the procedure (average time expected for the procedure is 30 minutes)
change in peak airway pressure
the investigator will record peak airway pressure
Time frame: at the baseline and at the end of the procedure (average time expected for the procedure is 30 minutes)
change in plateau airway pressure
the investigator will record plateau airway pressure
Time frame: at the baseline and at the end of the procedure (average time expected for the procedure is 30 minutes)
change in air-trapping
the investigator will record auto-PEEP at the of expiration as a measure of air-trapping
Time frame: at the baseline and at the end of the procedure (average time expected for the procedure is 30 minutes)
early complications
early complications are:multiple intubation attempts (more than 1), accidental extubation, paratracheal insertion, injuries to blood vessels in the neck, oesophageal injury, accidental decannulation, malposition of the tracheostomy tube, tracheal cuff puncture, multiple punctures (more than 1), surgical conversion and percutaneous tracheostomy failure, minor bleeding (compressible), major bleeding (incompressible), pneumothorax,
Time frame: in the first 24 hours from the end of the procedure
late complications
late complications are: minor bleeding (compressible), major bleeding (incompressible) tracheostomy puncture site infection, subglottic stenosis, fracture of a tracheal cartilage, granuloma.
Time frame: from the 2nd day ofter the procedure until the ICU discharge (expected average of 2 weeks)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.