Updates in percutaneous tracheostomy and gastrostomy: should we strive for combined placement during one procedure?

Andrew DeMaio, Lonny Yarmus

Journal: Current opinion in pulmonary medicine 2022;29(1):29-36

PMID: 36373725

Abstract

PURPOSE OF REVIEW

Percutaneous tracheostomy and gastrostomy are minimally invasive procedures among the most common performed in intensive care units. Practices across centres vary considerably, and questions remain about the optimal timing, performance and postoperative care related to these procedures.

RECENT FINDINGS

The COVID-19 pandemic has triggered a reevaluation of the practice of percutaneous tracheostomy and gastrostomy in the ICU. Combined percutaneous tracheostomy and gastrostomy at the bedside has potential benefits, including improved nutrition, decreased exposure to anaesthetics, decreased patient transport and decreased hospital costs. Percutaneous ultrasound gastrostomy is a novel technique that eliminates the need for an endoscope that may allow intensivists to perform gastrostomy at the bedside.

SUMMARY

Multidisciplinary care is essential to the follow up of critically ill patients receiving tracheostomy and gastrostomy. Combined tracheostomy and gastrostomy has numerous potential benefits to patients and hospital systems. Interventional pulmonologists are uniquely qualified to perform both procedures and serve on a tracheostomy and gastrostomy team.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Address: Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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