C-MAC Videolaryngoscopy Versus Direct Laryngoscopy for Percutaneous Tracheostomy

Condition(s) studied

Investigational drug(s) / intervention(s)

C-MAC videolayngoscopy technique: Endotracheal tube will be removed before percutaneous tracheostomy using a C-MAC videolaryngoscopy.

Laryngoscopy technique: Endotracheal tube will be removed before percutaneous tracheostomy using a laryngoscopy

Study summary

When preparing an ICU patient for percutaneous dilational tracheostomy, correct positioning of the endotracheal tube is important. During the procedure, it is possible to puncture the cuff. Tracheal tube cuff puncture can lead to failure of ventilation, loss of positive end-expiratory pressure, and possible aspiration of gastric contents blood or secretions. To minimize the risk, in our ICU, we withdraw the endotracheal tube under direct laryngoscopic vision until the cuff is visible at the vocal cords. This maneuver would also facilitate insertion of the Seldinger needle and insertion of the tracheostomy tube below the endotracheal tube. However, this maneuver to remove the endotracheal tube under direct laryngoscopy can sometimes be difficult. ICU patients present frecuently difficult laryngoscopic vision due to airway edema or secretions. In ICU, the videolaryngopy has been shown to be superior to direct laryngoscopy in visualization the upper airway, allowing better laryngoscopic vision.

Eligibility

Primary outcome measure(s)

• Introduction of the Seldinger needle below the endotracheal tube — during the procedure
  Percentage of patients in whom the introduction of the Seldinger needle is below the tip of the endotracheal tube

Trial sites (2)

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