Increasing the precision of simulated percutaneous dilatational tracheostomy-a pilot prototype device development study.
Health sciences
Respiratory medicine
Surgery
Journal
iScience
ISSN: 2589-0042
Titre abrégé: iScience
Pays: United States
ID NLM: 101724038
Informations de publication
Date de publication:
15 Mar 2024
15 Mar 2024
Historique:
received:
04
08
2023
revised:
30
11
2023
accepted:
30
01
2024
medline:
21
2
2024
pubmed:
21
2
2024
entrez:
21
2
2024
Statut:
epublish
Résumé
Percutaneous dilatational tracheostomy (PDT) is a bedside medical procedure which sites a new tracheostomy tube in the front of the neck. The critical first step is accurate placement of a needle through the neck tissues into the trachea. Misplacement occurs in around 5% of insertions, causing morbidity, mortality, and delays to recovery. We aimed to develop and evaluate a prototype medical device to improve precision of initial PDT-needle insertion. The Guidance for Tracheostomy (GiFT) system communicates the relative locations of intra-tracheal target sensor and PDT-needle sensor to the operator. In simulated "difficult neck" models, GiFT significantly improved accuracy (mean difference 10.0 mm, ANOVA p < 0.001) with ten untrained laboratory-based participants and ten experienced medical participants. GiFT resulted in slower time-to-target (mean difference 56.1 s, p < 0.001) than unguided attempts, considered clinically insignificant. Our proof-of-concept study highlights GiFT's potential to significantly improve PDT accuracy, reduce procedural complications and offer bedside PDT to more patients.
Identifiants
pubmed: 38380258
doi: 10.1016/j.isci.2024.109098
pii: S2589-0042(24)00319-5
pmc: PMC10877963
doi:
Types de publication
Journal Article
Langues
eng
Pagination
109098Subventions
Organisme : Medical Research Council
ID : MC_PC_19046
Pays : United Kingdom
Informations de copyright
© 2024 The Authors.
Déclaration de conflit d'intérêts
We, the authors, have a patent related to the work—publication of WO2023285826A1.
Références
J Intensive Care Med. 2023 Sep;38(9):878-883
pubmed: 37654071
Am J Respir Crit Care Med. 2015 Aug 15;192(4):446-54
pubmed: 25955332
Chest. 2005 Dec;128(6):3854-62
pubmed: 16354854
Int J Crit Illn Inj Sci. 2020 Oct-Dec;10(4):195-199
pubmed: 33850828
Arch Phys Med Rehabil. 2021 May;102(5):835-842
pubmed: 33166525
BJA Educ. 2021 Jul;21(7):250-257
pubmed: 34178381
Crit Care Med. 2005 Oct;33(10):2184-93
pubmed: 16215368
Eur Arch Otorhinolaryngol. 2021 May;278(5):1605-1612
pubmed: 32749607
Medicine (Baltimore). 2019 Aug;98(35):e16939
pubmed: 31464931
N Engl J Med. 2020 Nov 12;383(20):e112
pubmed: 33113296
Int Wound J. 2024 Jan;21(1):e14368
pubmed: 37736875
Chest. 2001 Aug;120(2):555-61
pubmed: 11502658
Acta Otolaryngol. 2021 Oct;141(10):953-959
pubmed: 34570658
Infect Control Hosp Epidemiol. 2004 Dec;25(12):1090-6
pubmed: 15636298
Int J Crit Illn Inj Sci. 2015 Jul-Sep;5(3):179-88
pubmed: 26557488
Br J Anaesth. 2011 May;106(5):632-42
pubmed: 21447489
Acute Crit Care. 2018 May;33(2):89-94
pubmed: 31723868
Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006;19(6-7):500-15
pubmed: 17100220
J Clin Med. 2021 Jun 16;10(12):
pubmed: 34208672
Br J Anaesth. 2020 Jul;125(1):e104-e118
pubmed: 32456776
Chest. 2002 Dec;122(6):2115-21
pubmed: 12475855
Laryngoscope. 2007 Mar;117(3):447-54
pubmed: 17334304
Br J Anaesth. 2015 Aug;115(2):155-8
pubmed: 25991759
BMJ Qual Improv Rep. 2017 May 23;6(1):
pubmed: 28607676
Br J Anaesth. 2020 Jul;125(1):e119-e129
pubmed: 32493580
Am J Respir Crit Care Med. 2002 Apr 1;165(7):867-903
pubmed: 11934711
Br J Anaesth. 2020 Dec;125(6):872-879
pubmed: 32988602
PLoS One. 2021 Oct 28;16(10):e0258972
pubmed: 34710141
Anesth Essays Res. 2013 Sep-Dec;7(3):402-4
pubmed: 25885993
Crit Care Med. 2003 May;31(5):1312-7
pubmed: 12771596
Thorax. 2021 Mar;76(3):302-312
pubmed: 33334908
Respir Care. 2005 Apr;50(4):511-5
pubmed: 15807913