Percutaneous dilatation tracheostomy which technique is the best for the critically ill patient, and how can we gather further scientific evidence 英文参考文献.docVIP

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Percutaneous dilatation tracheostomy which technique is the best for the critically ill patient, and how can we gather further scientific evidence 英文参考文献.doc

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Percutaneous dilatation tracheostomy which technique is the best for the critically ill patient, and how can we gather further scientific evidence 英文参考文献

Available online /content/8/5/319 Commentary Percutaneous dilatation tracheostomy: which technique is the best for the critically ill patient, and how can we gather further scientific evidence? Ansgar Brambrink Visiting Associate Professor, Oregon Health Science University, Department of Anesthesiology and Peri-Operative Medicine, Portland, Oregon, USA Corresponding author: Ansgar Brambrink, brambrin@ Published online: 8 September 2004 Critical Care 2004, 8:319-321 (DOI 10.1186/cc2968) This article is online at /content/8/5/319 ? 2004 BioMed Central Ltd Related to Research by Fikkers et al., see page 395 Abstract Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years, different technical solutions have been studied to assess their respective risks and benefits to determine whether one method is actually superior. A recent observational study comparing two such techniques prompted this commentary, which reviews the current literature, comments on study design and suggests interesting topics for future research in this field. Keywords conic dilatation technique, fiberoptic brochoscopy guidance, Griggs guide wire dilating forceps (GWDF) technique, intensive care medicine, percutaneous dilatation tracheostomy, study design, Numerous reports have been published in recent years performed immediately in an emergency situation to safeguard the airway. regarding various methods of percutaneous tracheostomy (for review [1–3]). One of the general conclusions is that techniques that require the use of sharp instruments (e.g. Griggs’ guidewire dilating forceps [GWDF] technique) apparently result in more complications. In addition, complications of percutaneous tracheostomy appear most likely to occur during the process of learning the technique – the ‘learning curve’. Several large clinical