Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni
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(2019) 7:9
Intensive Care Medicine Experimental
RESEARCH
Open Access
Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni’s translaryngeal tracheostomy procedure: trial on human cadavers Alessandro Terrani1,2* , Enrico Bassi3, Caterina Valcarenghi4, Emmanuel Charbonney5,6,7, Paul Ouellet7,8,9, Patrice Gosselin10, Giacomo Bellani1,11 and Giuseppe Foti1,11 * Correspondence: a.terrani@ campus.unimib.it 1 Department of Emergency and Intensive Care, ASST, Monza, Italy 2 Desio Hospital, Via Mazzini 1, Desio, Italy Full list of author information is available at the end of the article
Abstract Background: Percutaneous dilatational tracheostomy (PDT) is the most frequently performed procedure in patients requiring prolonged mechanical ventilation. A crucial step in such procedures is needle insertion into the trachea. To simplify this procedure and increase its safety, we developed a new device, the translaryngeal Tracheostomy Needle Introducer (tTNI), for use with Fantoni’s method. This cadaver study was designed to assess the performance of the tTNI on human anatomy. Methods: We tested the tTNI in a cadaver laboratory; the operators included two experts trained in PDT and three without specific training in the procedure. We performed 58 needle insertion attempts on 13 cadavers. We compared the tTNI technique with the standard needle insertion approach using external landmarks. We recorded the number of attempts needed to optimise needle insertion, time required in seconds, final position of the needle and complications related to needle insertion. Results: tTNI use resulted in fewer puncture attempts (1.91 ± 1.34 vs. 1.19 ± 0.5, p < 0.001), less time (36.8 ± 51.6 s vs. 13.14 ± 15.57 s, p < 0,001) and increased precision on the first puncture (18.87 ± 25.38° vs. 7.5 ± 12.95°, p < 0,005). We did not observe any complication with tTNI use, whereas complications found using the standard method were in line with the literature. Conclusions: The tTNI is a device that simplifies needle insertion by enhancing the accuracy of insertion with fewer attempts and higher precision, even when used by less experienced operators. Clinical testing is required to evaluate the device performance in patients. Keywords: Tracheostomy, Percutaneous, Translaryngeal tracheostomy, Needle introducer, Safety, Complications, Digital fabrication, 3D printing
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Terrani et al. Intensive Care Medicine Experimental
(2019) 7:9
Background Percutaneous dilatational tracheostomy (PDT) techniques are frequently used in patients who need tracheostomy for prolonged per
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