Assessment of the percutaneous dilatational tracheostomy technique in experimental manikins and canine cadavers.
OBJECTIVE
To evaluate procedure time, ease of placement, and complication rates of percutaneous dilatational tracheostomy (PDT) compared to surgical tracheostomy (ST) in canine cadavers.


DESIGN
Randomized crossover experimental manikin and cadaver study involving 6 novice veterinary students.


SETTING
University teaching hospital.


ANIMALS
Canine tracheostomy training manikin, 24 canine cadavers.


INTERVENTIONS
None.


MEASUREMENTS AND MAIN RESULTS
For training, each student performed 10 PDT and 10 ST procedures on a training manikin, followed by 2 PDT and 2 ST procedures on a canine cadaver. After each training procedure, feedback from bronchoscopy and observers was provided. Final PDT and ST tube placements using new equipment were performed in unused cadavers. Placements were timed, ease of placement was scored using visual analog scales (VAS, 0-10 cm), and complications were assessed by two independent observers using ordinal scales (0-3). Cadaver tracheas were explanted postprocedure to evaluate anatomical damage scores (0-3). Procedure time and VAS scores for PDT and ST procedures were analyzed using mixed-effects linear models, accounting for student, technique, and procedure number with post hoc pairwise comparisons. Data are presented as median (range). For the final cadaver placement, there were no significant differences in placement time (300 seconds [230-1020] vs 188 seconds [116-414], P = 0.210), ease of placement (3.8 cm [2.1-5.7] vs 1.9 cm [0-4.7], P = 0.132), anatomical damage score (1 [0-2] vs 0 [0-1], P = 0.063), or equipment complications score (0 [0-1] vs 0 [0-0], P = 1.000) between PDT and ST, respectively.


CONCLUSIONS
These data suggest that PDT can be performed as quickly, as easily, and as safely as ST in a canine cadaver by novice veterinary students following manikin training. Additional studies will be required to determine if these findings can be translated into veterinary clinical practice.
['Pardo|Mariana A|MA|', 'Sumner|Julia P|JP|', 'Friello|Adele|A|', 'Fletcher|Daniel J|DJ|', 'Goggs|Robert|R|https://orcid.org/0000-0001-7446-6987']
D000818:Animals D002102:Cadaver D018592:Cross-Over Studies D004285:Dogs D005260:Female D008297:Male D008348:Manikins D013647:Task Performance and Analysis D014139:Tracheostomy
complications trachea manikin training anatomic models upper airway obstruction