Modified technique of realtime ultrasound guided percutaneous balloon dilatational tracheostomy through laryngeal mask airway insertion

Background The technique of bedside percutaneous tracheostomy (BPT) has become a routine procedure in the ICU. As a common standard, a bronchoscope is used during the BPT in order to assess the upper airway anatomy and to assist guiding the needle while penetrating the tracheal inter-ring space into the correct central positioning. However, using the bronchoscope during the puncture of the trachea holds a potential patient safety risk due to the possibility of inaccurate device placement and associated temporary hypoventilation. Moreover, an accidental needle puncture of the bronchoscope is a frequent problem and leads to high repair costs as well as to prolonged downtime periods of the damaged device. It is therefore important to further improve the BPT technique aiming towards minimizing patient safety risks as well as eliminating avoidable technical and financial burdens for healthcare institutions.