Abstract
OBJECTIVE: This study aimed to investigate the clinical efficacy and safety of ultrasound localization with fiberoptic bronchoscopy-guided percutaneous tracheostomy (US-B PDT) in the intensive care unit (ICU) setting. METHODS: A retrospective analysis was conducted on 122 patients who underwent tracheostomy between August 2016 and December 2024 at the Department of Critical Care Medicine, Beijing Electric Power Hospital. Based on the surgical technique employed, patients were divided into two groups: the ultrasound localization and fiberoptic bronchoscopy-guided percutaneous dilatational tracheostomy group (US-B PDT group, n = 62) and the conventional percutaneous dilatational tracheostomy group (PDT group, n = 60). Surgical parameters and intraoperative and postoperative complications were compared between the two groups. RESULTS: Patients in the US-B PDT group demonstrated statistically significant improvements in several parameters compared to the PDT group, including shorter surgical duration (8.30 ± 0.51 vs. 10.42 ± 1.29 min, respectively), reduced intraoperative blood loss (9.91 ± 0.97 vs. 13.92 ± 0.82 ml, respectively), lower tracheal tube cuff leakage rate (0% vs. 13.3%, respectively), higher first-attempt intubation success rate (96.8% vs. 90.2%, respectively), and decreased sputum overflow rate at the tracheostomy site (3.2% vs. 18.3%, respectively), with p-values < 0.05 for all comparisons. Additionally, the incidence of complications in patients of the US-B PDT group (9.7%) was significantly lower than that in the PDT group (45%) (P < 0.05). Notably, no cases of damage to the posterior tracheal wall or tracheoesophageal fistula were observed in either group. CONCLUSION: The use of US-B PDT significantly shortened surgical duration, reduced intraoperative blood loss, lowering tracheal tube cuff leakage, enhancing first-attempt intubation success rate, and preventing complications such as posterior tracheal wall injury and tracheoesophageal fistula, ensuring superior safety. These findings highlight the safety and efficacy of this surgical approach for widespread use in ICUs equipped with the necessary facilities.