CHEST Guidelines-Assessment-of-Ventilation-During-the-Performance-o (1)

Assessment-of-Ventilation-During-the-Performance-o (1)

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The correspondence in the July 2015 issue of CHEST discusses a study by Vargas et al., which evaluates a new double-lumen endotracheal tube (DLET) for use in percutaneous dilatational tracheostomies (PDT). The letter by Dr. Fausto Ferraro and colleagues criticizes the study, questioning the DLET's compatibility with retrograde procedures like the Fantoni translaryngeal tracheostomy. They cite limitations in the DLET's endoscopic vision and the potential risks associated with its use, particularly in patients with smaller glottis or during tube exchanges without clear visibility. They argue this could lead to complications similar to those encountered with conventional endotracheal tubes (ETTs) and assert that their own previously published method, which maintains continuous ventilation and broader endoscopic vision, is safer.<br /><br />In response, Dr. Maria Vargas and co-authors affirm the feasibility of DLET in PDT while acknowledging its current incompatibility with the Fantoni technique. They defend the DLET position, highlighting its ability to ensure uninterrupted endoscopic vision between the vocal cords and the carina. They also justify their study's outcomes by referring to significant statistical power, suggesting their sample size was indeed adequate. Additionally, they claim that their technique does not impede ventilation or vision, as opposed to the method proposed by Ferraro et al.<br /><br />Both parties agree that further studies are necessary to refine and expand the understanding of the optimal use of DLETs in tracheostomy procedures. This exchange underscores the ongoing debates in medical practices related to enhancing the safety and efficacy of airway management techniques.

Keywords

double-lumen endotracheal tube

percutaneous dilatational tracheostomy

Fantoni translaryngeal tracheostomy

endoscopic vision

glottis

tube exchanges

ventilation

airway management

medical practices

tracheostomy procedures