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

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.
Author(s): Alfonso Fiorelli [sup.1] , Fausto Ferraro [sup.2] , Elisabetta Frongillo [sup.1] , Pierluigi Fusco [sup.2] , Matteo Pierdiluca [sup.1] , Francesca Nagar [sup.2] , Angela Iuorio [sup.2] , Mario [...]