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Percutaneous Dilatational Tracheostomy Using Tube Exchanger

Ronen, Ohad MD*,†; Gurevich, Alexander MD; Ivry, Shimon MD; Altman, Edward MD§; Kukuev, Evgeni MD

doi: 10.1213/ANE.0000000000003321
Patient Safety
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We describe a modified technique for percutaneous dilatational tracheostomy using a 15F tube exchanger or Eschmann catheter. A retrospective review of 1180 procedures using this modified technique demonstrated it to be effective with a failure rate of only 0.25% (3 patients). Moreover, it provides an additional safeguard with the ability to rapidly reintroduce the endotracheal tube into the trachea guided by the exchange catheter in the event of accidental extubation during the procedure. This technique needs no additional special devices or equipment (eg, a bronchoscope). However, a prospective study is needed to better define its complication rate.

From the *Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel

Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

Department of Anesthesiology, Galilee Medical Center, Nahariya, Israel

§Surgery B, Galilee Medical Center, Nahariya, Israel.

Published ahead of print 22 January 2018.

Accepted for publication January 22, 2018.

Funding: None.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Ohad Ronen, MD, Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, POB 21, Nahariya 2210001, Israel. Address e-mail to ohadr@gmc.gov.il.

Copyright © 2018 International Anesthesia Research Society
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