Az antropometriai paraméterek szerepe a cadaveren végzett percutan tracheostomás módszerekben

Abstract

For patients requiring prolonged mechanical ventilation, tracheostomy becomes necessary, which may be performed through surgical or percutaneous methods. In this study, we used three different methods of percutaneous dilatational tracheostomy. Our goal was to identify anthropometric parameters relevant for the correct position of the tracheostomy tube. Randomized, controlled observational study was performed on 118 cadavers. Three different tracheostomy methods were used: the Griggs (n = 37), the Griggs modified by Élő (n = 45), and the Ciaglia's Blue Rhino (n = 36). The neck circumference, jugulomental distance, and mid-upper arm circumference were measured on each cadaver. We assessed whether the aforementioned parameters related with the appropriate positioning of the tracheostomy tube Results: Significant correlation was found (p = 0.0287) between mid-upper arm circumference and incorrect tracheostomy tube position (below the fourth tracheal cartilage ring). We identified the value of 30 cm of mid-upper arm circumference as the ideal cut-off for predicting tube malposition (sensitivity: 63.63%, specificity: 60.22%). When planning percutaneous tracheostomy, it is important to measure the anthropometric parameters. If mid-upper arm circumference is 30 cm or higher we recommend other tests and/or ENT (ear, nose, and throat) consultation. Orv Hetil. 2023; 164(16): 630-635.