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Báo cáo y học: "Percutaneous dilatation tracheostomy: which technique is the best for the critically ill patient, and how can we gather further scientific evidence"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Percutaneous dilatation tracheostomy: which technique is the best for the critically ill patient, and how can we gather further scientific evidence? | Available online http ccforum.eom content 8 5 319 Commentary Percutaneous dilatation tracheostomy which technique is the best for the critically ill patient and how can we gather further scientific evidence Ansgar Brambrink Visiting Associate Professor Oregon Health Science University Department of Anesthesiology and Peri-Operative Medicine Portland Oregon USA Corresponding author Ansgar Brambrink brambrin@ohsu.edu Published online 8 September 2004 This article is online at http ccforum.com content 8 5 319 2004 BioMed Central Ltd Related to Research by Fikkers et al. see page 395 Critical Care 2004 8 319-321 DOI 10.1186 cc2968 Abstract Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years different technical solutions have been studied to assess their respective risks and benefits to determine whether one method is actually superior. A recent observational study comparing two such techniques prompted this commentary which reviews the current literature comments on study design and suggests interesting topics for future research in this field. Keywords conic dilatation technique fiberoptic brochoscopy guidance Griggs guide wire dilating forceps GWDF technique intensive care medicine percutaneous dilatation tracheostomy study design Numerous reports have been published in recent years regarding various methods of percutaneous tracheostomy for review 1-3 . One of the general conclusions is that techniques that require the use of sharp instruments e.g. Griggs guidewire dilating forceps GWDF technique apparently result in more complications. In addition complications of percutaneous tracheostomy appear most likely to occur during the process of learning the technique -the learning curve . Several large clinical trials reported a rather low incidence of complications with various percutaneous tracheostomy techniques