Percutaneous dilatational tracheostomy with a double-lumen endotracheal tube: A comparison of feasibility, gas exchange, and airway pressures

OBJECTIVE: Gas exchange and airway pressures are markedly altered during percutaneous dilatational tracheostomy (PDT). A double-lumen endotracheal tube (DLET) has been developed for better airway management during PDT. Th e current study prospectively evaluated the in vivo feasibility, gas exchange, and airway pressures during PDT with DLET compared with a conventional endotracheal tube (ETT). METHODS: According to eligibility criteria, patients were divided into a case group (those receiving PDT with DLET) and a control group (those receiving PDT with a conventional ETT). Th e Ciaglia single-dilator technique was used for PDT in both groups. Th e primary end point of this study was the feasibility of tracheostomy with DLET. Th e secondary end points were a comparison of gas exchange, airway pressures, minute volume, and tidal volume before, during, and aft er PDT performed with DLET and conventional ETT. RESULTS: Ten patients meeting the inclusion criteria were assigned to each group. PDTs were performed without diffi culties in nine patients in the DLET group and 10 patients in the conventional ETT group. During PDT, gas exchange, airway pressures, and minute ventilation remained more stable in the DLET group and were signifi cantly diff erent from those in the conventional ETT group. CONCLUSIONS: PDT with DLET can be performed safely without diffi culties limiting the technique. Furthermore, during PDT, the use of the DLET resulted in more stable gas exchange, airway pressures, and ventilation than PDT with a conventional ETT. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01691222; URL: www.clinicaltrials.gov.