Work

Air Way Management in Mini‐Surgical Percutaneous Dilatational Tracheostomy Using Endotracheal Tube and Supraglottic Airway Devices (I‐Gel, Laryngeal Mask Airway, and LarySeal) Classical and Ultrasound Point of View: A Prospective Cohort Study

Year: 2025

Type: article

Abstract: ABSTRACT Background and Aims Mini‐surgical percutaneous dilatational tracheostomy (msPDT) offers a streamlined alternative to conventional tracheostomy, yet the optimal airway management device for this procedure remains underexplored. This study compares the efficacy and safety of endotracheal tubes (ETTs) versus supraglottic airway devices (SADs: I‐gel, LMA, LarySeal) during msPDT. Methods In this prospective cohort study, 464 mechanically ventilated patients underwent msPDT between 2015 and 2023. Patients were stratified into four groups: ETT ( n = 90), I‐gel ( n = 180), LMA ( n = 180), and LarySeal ( n = 14). Procedural duration, hemodynamic parameters, oxygenation, and complications were analyzed. Ultrasound imaging assessed tracheal alignment and device‐related anatomical changes. Results Procedural time was shortest with LMA (1.8 ± 0.65 min) and I‐gel (1.9 ± 0.62 min), compared to ETT (2.2 ± 0.68 min) and LarySeal (2.0 ± 0.66 min). The LarySeal group exhibited a higher pneumothorax incidence (7.1% vs. 0%–2.2% in other groups, p = 0.079) and tracheal displacement on ultrasound. Hemodynamic stability and oxygenation were comparable across groups, though SpO₂ declines were more frequent with ETT (5.6% vs. ≤ 1.7% for SADs). Conclusion I‐gel and LMA optimize msPDT efficiency and safety, while LarySeal's anatomical interference warrants caution. Ultrasound‐guided device selection enhances procedural precision, advocating for SADs as first‐line tools in msPDT.

Source: Health Science Reports

DOI: 10.1002/hsr2.71642