Navigation System for Percutaneous Tracheotomy
研究概览
详细说明
Percutaneous tracheotomy is a well-established method. Anatomical landmarks need to be identified. We introduce a new method that increases precision through three-dimensional navigation with a new instrument - SafeTrach.
SafeTrach is a pliers-like instrument. The inner shank acts as a ventilation tube while stabilizing the orotracheal tube in the trachea. The outer shank acts as a three-dimensional control instrument for the puncture needle.
We determined the puncture level in 20 patients using SafeTrach. We found that the distance from the vocal cords to the puncture site was about 45 mm for men and 42 mm for women. This was based on intraoperative measurements. In 13 patients, we studied the distance between the vocal cords and the optimal puncture site between the 2nd and 3rd tracheal ring with CT and found that the mean distance for men was 49.8 mm and for women 42.2 mm. We have used internal measurements in another 12 patients as follows: The orotracheal tube is positioned so that the proximal part of the cuff is just below the vocal cords. 2. The position of the tube is measured against the front teeth. 3. The orotracheal tube together with the inner shank is pulled up about 15 mm for both men and women. This means that part of the cuff lies between the vocal cords and you get an acceptable placement of the puncture needle.
By using SafeTrach you can use internal landmarks to indicate the puncture level. The positioning of the leg is done with high precision because SafeTrach acts as a stable guide. The navigation system minimizes the risk of extubation and damage to the posterior tracheal wall.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Solna
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Stockholm、Solna、瑞典、171 64
- Karolinska University Hospital
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Patients age >18 years old
- Patients requiring PDT for prolonged mechanical ventilation, airway protection or weaning failure
Exclusion Criteria:
- Pediatric patients
- Emergency tracheotomies
- Anatomical abnormalities due to hematoma/tumor/scarring from previous neck surgery/thyromegaly/unstable C-spine and difficult local anatomy. (Patients with obesity are not considered to be a hindrance for the SafeTrach technique as the location for puncture easily can be decided with help of the outer and inner shanks).
- Contra indication for re-intubation (suspected loss of airway during re-intubation)
- Coagulation abnormalities - INR>1.5, PTT >40, thrombocyte count <50.000
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Percutaneous tracheotomy using a new device
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The navigation system is a forceps-like instrument with an outer and an inner shank.
The inner shank serves as a ventilation lumen and stabilizes the orotracheal tube in the midline of trachea.
The outer shank acts as a three-dimensional guide for the puncturing needle to the midline of trachea
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Navigation System for Percutaneous Tracheotomy
大体时间:30 minutes
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Precision of puncture site
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30 minutes
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合作者和调查者
调查人员
- 首席研究员:Jonas Karling, Ph.D、Karolinska Institutet
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- SafeTrach 1
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
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SafeTrach for tracheotomy的临床试验
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Mary LacyNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)主动,不招人
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Florida International UniversityCare 4 U Management, Inc.; Care Resource Community Health Centers, Inc.; Monarch Health Services...完全的
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University of California, Los AngelesUniversity of California, Davis; California Department of Health Services完全的
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Florida State UniversityUniversity of North Carolina, Chapel Hill; University of Georgia邀请报名
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University of PittsburghAllegheny County Department of Human Services, Area Agency on Aging招聘中