Skip to main content
SpringerLink
Log in

Percutaneous dilatational tracheostomy using the ETView Tracheoscopic Ventilation Tube®: a teaching course in a pig model

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Objective

We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model.

Methods

The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model. The participants were asked to perform PDT in three different sessions to improve their dexterity. The primary endpoint was the reduction of complications seen during the different sessions of the training course. The secondary endpoint was the satisfaction of the participants as assessed by an anonymous survey.

Results

Thirty-seven residents in anesthesiology and 7 in thoracic surgery in the first 2 years of their training and without any confidence with percutaneous tracheostomy participated in the study. Tracheal cuff lesions and impalement of the tracheal tube were the most observed complications, and were concentrated in the early sessions. A significant reduction in complications and operative time was seen during the ongoing sessions of the course. No lesions of the posterior tracheal wall and only a ring fracture occurred during the last session of the course. All participants were satisfied with the course.

Conclusions

Our course seems to confer the technical skills to perform percutaneous tracheostomy to trainees and instill confidence with the procedure. However, the experience acquired on a training course should be evaluated in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest. 1985;87:715–9.

    Article  CAS  PubMed  Google Scholar 

  2. Fiorelli A, Carelli E, Angioletti D, Orsini A, D’Elia A, Torino A, Santini M, Ferraro F. A home-made animal model in comparison with a standard manikin for teaching percutaneous dilatational tracheostomy. Interact Cardiovasc Thorac Surg. 2015;20:248–53.

    Article  PubMed  Google Scholar 

  3. Fiorelli F, Ferraro F, Milione R, Scarumuzzi R, Imitazione P, Marulli L, Orsini A, Santini M. Percutaneous dilatational tracheostomy using a tracheoscopic ventilation tube in an experimental ex vivo animal model. Anaesth Intensive Care. 2016;44:371–5.

    CAS  PubMed  Google Scholar 

  4. Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ Theory Pract. 2010;15:625–32.

    Article  PubMed  Google Scholar 

  5. Escarment J, Suppini A, Sallaberry M, Kaiser E, Cantais E, Palmier B, Quinot JF. Percutaneous tracheostomy by forceps dilation: report of 162 cases. Anaesthesia. 2000;55:125–30.

    Article  CAS  PubMed  Google Scholar 

  6. Massick DD, Powell DM, Price PD, Chang SL, Squires G, Forrest LA, Young DC. Quantification of the learning curve for percutaneous dilatational tracheotomy. Laryngoscope. 2000;110:222–8.

    Article  CAS  PubMed  Google Scholar 

  7. Zamponi E, Zanaboni S, Maestrone C, Della Corte F, Pelosi G. Learning curve in performing translaryngeal tracheostomy. Intensive Care Med. 2003;29:1031.

    Article  PubMed  Google Scholar 

  8. Cho J, Kang GH, Kim EC, Oh YM, Choi HJ, Im TH, Yang JH, Cho YS, Chung HS. Comparison of manikin versus porcine models in cricothyrotomy procedure training. Emerg Med J. 2008;25:732–4.

    Article  CAS  PubMed  Google Scholar 

  9. Terragni P, Mascia L, Faggiano C, Tenaglia T, Morello E, Succo G, Ranieri M, Brazzi L. A new training approach in endoscopic percutaneous tracheostomy using a simulation model based on biological tissue. Minerva Anestesiol. 2016;82:196–201.

    PubMed  Google Scholar 

  10. Cipriano A, Mao ML, Hon HH, Vazquez D, Stawicki SP, Sharpe RP, Evans DC. An overview of complications associated with open and percutaneous tracheostomy procedures. Int J Crit Illn Inj Sci. 2015;5:179–88.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Al-Ansari MA, Hijazi MH. Clinical review: percutaneous dilatational tracheostomy. Crit Care. 2006;10:202.

    Article  PubMed  Google Scholar 

  12. Ferraro F, Marfella R, Esposito M, Petruzzi J, Torino A, d’Elia A, Santini M, Fiorelli A. Tracheal ring fracture secondary to percutaneous tracheostomy: is tracheal flaccidity a risk factor? J Cardiothorac Vasc Anesth. 2015;29:560–4.

    Article  PubMed  Google Scholar 

  13. Fiorelli A, Mazzone S, Di Crescenzo VG, Costa G, Del Prete A, Vicidomini G, Mazzone A, Santini M. A simple technique to control placement of Dumon stent in subglottic tracheal stenosis. Interact Cardiovasc Thorac Surg. 2014;18:390–2.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Piazza Miraglia 3, 80100, Naples, Italy

    Alfonso Fiorelli, Elisabetta Frongillo, Matteo Pierdiluca & Mario Santini

  2. Anesthesiology and Intensive Care Unit, Seconda Università degli Studi di Napoli, Naples, Italy

    Fausto Ferraro, Pierluigi Fusco, Francesca Nagar & Angela Iuorio

Authors
  1. Alfonso Fiorelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fausto Ferraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elisabetta Frongillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pierluigi Fusco
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matteo Pierdiluca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francesca Nagar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Angela Iuorio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mario Santini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alfonso Fiorelli.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fiorelli, A., Ferraro, F., Frongillo, E. et al. Percutaneous dilatational tracheostomy using the ETView Tracheoscopic Ventilation Tube®: a teaching course in a pig model . J Anesth 31, 751–757 (2017). https://doi.org/10.1007/s00540-017-2394-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-017-2394-3

Keywords

Search

Navigation