Percutaneous dilatational tracheostomy (PDT) is a bedside medical procedure which sites a new tracheostomy tube in the front of the neck. The critical first step is accurate placement of a needle through the neck tissues into the trachea. Misplacement occurs in around 5% of insertions, causing morbidity, mortality, and delays to recovery. We aimed to develop and evaluate a prototype medical device to improve precision of initial PDT-needle insertion. The Guidance for Tracheostomy (GiFT) system communicates the relative locations of intra-tracheal target sensor and PDT-needle sensor to the operator. In simulated "difficult neck" models, GiFT significantly improved accuracy (mean difference 10.0 mm, ANOVA p < 0.001) with ten untrained laboratory-based participants and ten experienced medical participants. GiFT resulted in slower time-to-target (mean difference 56.1 s, p < 0.001) than unguided attempts, considered clinically insignificant. Our proof-of-concept study highlights GiFT's potential to significantly improve PDT accuracy, reduce procedural complications and offer bedside PDT to more patients.
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http://dx.doi.org/10.1016/j.isci.2024.109098 | DOI Listing |
J Clin Med
January 2025
Ruth and Bruce Rappaport Faculty of Medicine, Technion, 1 Efron St. Bat Galim, Haifa 3525433, Israel.
: Patients with hematologic malignancy (HM) often experience high rates of thrombocytopenia, thrombocytopathy, anemia, leukopenia, and coagulopathy, which can significantly increase the risk of procedural and postoperative complications. This study aimed to evaluate the safety and outcomes of percutaneous dilatational tracheostomy (PDT) in critically ill patients with HM. : This retrospective cohort study included patients with HM who underwent PDT between 2012 and 2023 at a tertiary academic center.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital; Henan Provincial Cerebrovascular Interventional Innovation Engineering Technology Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou, Henan, China
Objective: This study aimed to examine the effect of drug-coated balloons (DCBs) on vascular luminal dilatational remodeling (VLDR) following simple balloon angioplasty.
Methods: A retrospective cohort study was conducted using data from patients diagnosed with intracranial atherosclerotic stenosis (ICAS), who were treated exclusively with balloon angioplasty at Henan Provincial People's Hospital between June 2019 and April 2023. Inverse probability weighting (IPW) was used to create balanced cohorts of patients who underwent drug-coated balloon angioplasty (DCBA) and plain old balloon angioplasty (POBA).
ANZ J Surg
December 2024
Department of Trauma Surgery, Gachon University Gil Medical Centre, Incheon, Republic of Korea.
Background: Tracheostomy is performed in patients with trauma who need prolonged ventilation for respiratory failure or airway management. Although it has benefits, such as reduced sedation and easier care, it also has risks. This study explored the unclear timing, technique, and patient selection criteria for tracheostomy in patients with trauma.
View Article and Find Full Text PDFJ Bronchology Interv Pulmonol
January 2025
Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
J Clin Anesth
December 2024
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany. Electronic address:
Background: Detailed reports are scarce on minimally-invasive tracheostomy (MIT) techniques for critically ill patients with challenging anatomy or complex coagulopathies. In such high-risk patients, conventional percutaneous dilatational tracheostomy (PDT) may lead to severe complications.
Methods: Aiming to broaden the scope of MIT for patients previously excluded due to high risks, we developed a new care bundle (MIT technique), specifically designed for intensive care specialists.
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