Comparison of efficacy and safety of ultrasonography and fiber optic bronchoscope guided percutaneous dilatational tracheostomy: A prospective observational study running title: Efficacy and safety of USG and FOB guided tracheostomy

Abstract

Introduction: We aimed to compare the procedural time, efficacy, and incidence of complications of ultrasonography and fiberoptic bronchoscope-guided percutaneous dilatational tracheostomy (PDT). Methods: The study population included the patients admitted to the department of anesthesiology and critical care. In this prospective observational study, we randomly divided 60 participants into two groups. In the ultrasound (US)-guided group, ultrasonography was used for PDT. While in the FOB guided group, we used the fiberoptic bronchoscope (FOB). We compared efficacy parameters and complications between the two groups. The mean values were compared between study groups using an independent sample t-test. Categorical outcomes were compared using the chi-square test. P-value < 0.05 was considered statistically significant. Results: Compared with the bronchoscopy group, the US group had a significantly shorter PDT operation time (11.8 ± 2.5 versus 15.43 ± 3.27 mins, P < 0.001). FOB group had fewer puncture attempts than the US group. FOB group had more central punctures than the US group (p < 0.001). Among PDT complications, bleeding happened in two patients (6.67%) in the FOB group and tracheal tube cuff puncture was observed in 8 (26.67%) patients in the US group. Conclusion: The US-guided PDT consumes less time for the procedure compared to bronchoscope-guided PDT. FOB was more effective in terms of parameters like the number of needle puncture attempts, the accuracy of the puncture site, the incidence of the posterior tracheal wall hit compared to US-guided PDT. Complications like bleeding were present in FOB.

Keywords

• bleeding
• fiberoptic bronchoscope
• percutaneous dilational tracheotomy
• ultrasonography