Evaluation Of The Effect Of Morphological Structure On Dilatational Tracheostomy Interference Location And Complications

Study Overview
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Brief Summary
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In recent years, percutaneous dilatational tracheostomy has become a frequently performed procedure in intensive care units. However, tracheostomy procedure has risks of complications of varying severity, such as bleeding, subcutaneous emphysema, posterior tracheal wall damage, tracheal stenosis, infection, and fistula in the early and late periods. It is important to determine the anatomical position for tracheal puncture in reducing the risk of complications. It is not always possible to determine the optimal anatomical position for tracheal puncture in patients in the intensive care unit due to reasons such as obesity patient positioning difficulties and tracheal deviation. In this stuy, we have purpose to evaluate the effect of the morphological structure of patients on the dilatational tracheostomy interference location and complications in the percutaneous dilatational tracheostomy procedure (using anatomical landmarks) performed with the forceps dilatation technique, using fiberoptic bronchoscopy and ultrasonography.

Detailed Description
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A prospective observational study will be conducted in the Akdeniz University Hospital at the department of Anesthesiology and Intensive Care. Tracheostomy incision site will be determined by using anatomical landmark in all patients. Before the procedure, detailed anatomical measurements showing the morphological structure of the patient (neck thickness, thyromental distance, thyroid cartilage measurement, cricoid cartilage measurement, jugulomental distance, distance between clavicle and cricoid cartilage) will be recorded. In addition, measurements will be made and recorded by ultrasonography. In all patients, the percutaneous dilatational tracheostomy procedure will be performed via fiberoptic bronchoscopy and the tracheal puncture level will be confirmed. Tracheostomy related complications will also be recorded.

Official Title
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Evaluation Of The Effect Of Morphological Structure On Dilatational Tracheostomy Interference Location And Complications By Ultrasonography And Fiberoptic Bronchoscopy

Conditions
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Tracheostomy Complication

Intervention / Treatment
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* Procedure: Percutaneous dilatational tracheostomy
* Device: Bronchoscopy
* Device: ultrasonography
* Diagnostic Test: Bronchoscopy application
* Diagnostic Test: Ultrasound examination


Participation Criteria
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Eligibility Criteria
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Example: ● Patients undergoing percutaneous dilatational tracheotomy Inclusion Criteria: ● Clinical indication for tracheostomy Exclusion Criteria: Age <18 Patients with severe coagulopathy Unsuitable anatomy (e.g., previous cervical surgery, cervical trauma, or tumors)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| percutaneous dilatational tracheostomy<br>Patients assigned to percutaneous dilatational tracheostomy | Procedure: Percutaneous dilatational tracheostomy<br>* The percutaneous dilatational tracheostomy procedure will be performed via fiberoptic bronchoscopy<br>Device: Bronchoscopy<br>* Fiberoptic bronchoscopy<br>Device: ultrasonography<br>* ultrasonography<br>Diagnostic Test: Bronchoscopy application<br>* Fiberoptic bronchoscopy application<br>Diagnostic Test: Ultrasound examination<br>* Ultrasound examination<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The effect of morphological structure on the percutaneous dilatational tracheostomy | The relationship of anatomical position for tracheal puncture and complications with morphological structure of the patient (neck thickness, thyromental distance, thyroid cartilage measurement, cricoid cartilage measurement, jugulomental distance, distance between clavicle and cricoid cartilage) | April 30, 2023-October 30, 2023 (6 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Complications, Intensive care unit, Tracheostomy