A new endotracheal tube designed to enable a single operator to perform percutaneous dilatational tracheostomy while maintaining the airway, providing continuous bronchoscopic guidance, and minimizing procedural complications: demonstration of feasibility on a mannequin and a cadaver

J Bronchology Interv Pulmonol. 2011 Oct;18(4):368-73. doi: 10.1097/LBR.0b013e318237286f.


Background: : We designed a double-lumen endotracheal tube (the EZ [Easy] Tracheostomy [EZT]) to enable a single operator to safely perform percutaneous dilatational tracheostomy (PDT) at the bedside while providing continuous bronchoscopic guidance. The EZT design also aims to ensure uninterrupted mechanical ventilation during most of the PDT procedure via a secure airway. It aims to significantly minimize hypoxia, hypoventilation, auto-positive end-expiratory pressure, airway loss, posterior wall laceration, and damage to the endoscope related to the current methodology.

Method: : We demonstrated the feasibility of our method on a mannequin model and a cadaver.

Results: : Single operators successfully performed the modified PDT on their first attempt with excellent visualization and no obvious complications. The potential for minimal interruption in ventilation, low risk of airway loss or malpositioning, and significant reduction in other PDT-related complications were clearly demonstrated. The procedure was found to be easier to perform when compared with conventional PDT.

Conclusions: : It is feasible for a single operator to perform PDT with continuous bronchoscopic guidance when using the EZT on cadaver and mannequin models. Clinical studies are warranted to evaluate this new tool.