Читать книгу Mount Sinai Expert Guides - Группа авторов - Страница 126

 The use of bronchoscopic guidance during tracheostomy is not routinely required and in at least one study did not result in better outcomes.

 It allows for positioning of the ETT and the placement of the needle under direct visualization.

 Bronchoscopy may be of more use in complicated cervical collar patients or the obese; or acutely if uncertainties arise during the procedure.

 The advantages of bronchoscopy include: real‐time needle‐tip localization during the procedure with less needle punctures; confirmation of endoluminal placement and supracarinal measurement; and if there is dislodgment of the ETT or TT during the procedure it can guide replacement.

 The disadvantages include: additional equipment and personnel (bronchoscopist) and greater cost. Bronchoscopy can obstruct the airway with possible impaired ventilation.