Comparative Study between Ultrasound-guided Percutaneous Dilatational Tracheostomy Versus Bronchoscopy-guided Percutaneous Dilatational Tracheostomy in Mechanically Ventilated Critically Ill Patients

Document Type : Original Article

Authors

1 Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Egypt

2 Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Egypt

3 GOTHI, El Sahel Teaching Hospital, Assistant clinical fellow of Intensive care medicine

Abstract

ABSTRACT

Background: Percutaneous dilatational tracheostomy (PDT) is widely practiced among critically ill patients in intensive care units (ICUs) owing to its safety. Medical professionals increasingly use fiberoptic bronchoscopy or ultrasound for PDT guidance instead of blind procedures. The objective of our study was to compare the safety and efficacy of ultrasound-guided PDT to bronchoscopy-guided PDT in critically ill ventilated patients.

Patients and methods: 40 adult patients were prospectively randomized into two groups: Group I (n=20) guided by bronchoscopy and Group II (n=20) guided by ultrasound.

Results: Group II had a significantly shorter procedural duration (P < 0.001). No significant differences emerged in intubation reasons, ventilation duration before tracheostomy, or tracheostomy motives. Procedural challenges, complications, and outcomes were comparable between both groups. Moreover, pre- and post-procedure P/F ratios, ICU or hospital stay length, and mortality rates showed no notable differences.

Conclusion: Ultrasound or bronchoscopy guided PDT in critically ill patients showed comparable results in terms of complications and outcomes. However, a significant difference was noted in procedural duration.

Keywords: Percutaneous dilatational tracheostomy, the intensive care units, bronchoscopy-guided group, the ultrasound-guided group.

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Zagazig University Medical Journal
Volume 31, Issue 7
July 2025
Pages 2832-2844

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