Evolution of Percutaneous Dilatational Tracheostomy—A Review of Current Techniques and Their Pitfalls
Bibliographic record
Abstract
Tracheostomy is the most commonly performed surgical procedure in critically ill patients with acute respiratory failure. While few absolute indications exist, this procedure is widely used in patients with upper respiratory obstruction and those requiring long-term mechanical ventilation. The traditional approach to tracheostomy has been an open procedure performed in the operating room. This method is associated with an increased rate of complications and costs. Accordingly, percutaneous bedside tracheostomy procedures have largely replaced the traditional operative approach at many institutions. Numerous methods for percutaneous tracheostomy have thus emerged. However, the benefits of one technique versus another have not been well demonstrated. In this article, we review the evidence supporting the use of percutaneous tracheostomy procedures over the traditional operative approach. Furthermore, we review the currently available and emerging methods by which percutaneous tracheostomy can be performed. In addition, we highlight the available evidence concerning the safety and complication rates of each technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".