CHEST Guidelines-Response_chest

Response_chest_12 (1)

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This document comprises a correspondence section from the "CHEST" journal where authors respond to comments on their previous study concerning percutaneous dilatational tracheostomy (PDT) using a double-lumen endotracheal tube (DLET). Dr. Ferraro and colleagues critiqued this device's suitability for the Fantoni translaryngeal tracheotomy (TLT), to which the authors agreed, pointing out potential for future design modifications for better compatibility. They highlight that TLT is uncommon in Italy and even less in other parts of Europe, emphasizing a need to improve ventilation during TLT procedures.<br /><br />The original study, in part, reported the successful use of DLET during PDT, achieving its primary objective in 100% of the patients. Despite encountering a complication with guidewire kinking, the procedures were successfully concluded using DLET, affirming the technique's viability. They argue that DLET, made from transparent polyvinyl chloride, supports endoscopic visibility without affecting tracheal exploration. They contrast this with the methodology proposed by Ferraro et al., which they believe could negatively impact ventilation and endoscopic vision due to issues with tube stability.<br /><br />Furthermore, the authors contend that DLET is distinguished in providing posterior tracheal wall protection without gas exchange or airway pressure deviations during PDT. They advocate for further exploration to define optimal uses and contraindications of the DLET in such contexts. The article closes, acknowledging contributions and affiliations across several Italian universities and Massachusetts General Hospital, reinforcing a collaborative research approach.

Keywords

percutaneous dilatational tracheostomy

double-lumen endotracheal tube

Fantoni translaryngeal tracheotomy

ventilation improvement

guidewire kinking

endoscopic visibility

tracheal exploration

posterior tracheal wall protection

Massachusetts General Hospital

Italian universities