tailieunhanh - Ebook Principles and practice of percutaneous tracheostomy: Part 2

(BQ) Part 2 book "Principles and practice of percutaneous tracheostomy" presents the following contents: Balloon facilitated percutaneous tracheostomy, percutaneous dilatational tracheostomy with ambesh t-trach kit, percutaneous dilational tracheostomy in special situations, percutaneous tracheostomy versus surgical tracheostomy, care of tracheostomy and principles of endotracheal suctioning,. | INTRODUCTION All minimally invasive techniques of tracheostomy have two independent steps in common dilatation of pretracheal tissues and the anterior tracheal wall and the cannula insertion performed in subsequent order. Only translaryngeal tracheostomy TLT is different in that dilatation is achieved with the tracheostomy cannula itself. However TLT is performed in retrograde reverse fashion . from inside the trachea to the outside and is technically quite sophisticated when compared to antegrade techniques. The Griggs technique was reported to have significant major perioperative complications whereas the Blue Rhino technique showed less severe but still potentially significant perioperative Dilatation and cannula placement in separate steps may contribute to some problems and risks. The more manipulation is posed to the airway the higher is the risk of airway injury bleeding creating false passages or entirely loosing the airway. Therefore it seemed desirable to develop an antegrade tracheostomy technique that combines tracheal dilatation and cannula placement in one single step. Shortly before his death in 2000 at the age of 88 years the pioneer of modern percutaneous tracheostomy Pasquale Ciaglia came up with an idea of balloon facilitated percutaneous tracheostomy BFPT an innovative one-step technique. His preliminary visions were further refined by Michael Zgoda pulmonologist at the University of Kentucky Lexington KY USA. The basic idea behind BFPT was - like Seldinger s guide wire technique - adopted from radiologists who are using balloon dilation for a variety of interventional procedures for almost ages. This technique utilizes a means of dilatation that does not require entry into the trachea by downward pressure using a hard dilatational device which theoretically could decrease the risk of posterior tracheal wall injuries. APPARATUS AND THE PROCEDURE BFPT combines dilatation and cannula placement in one single step. First a 15-20