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Impact of real-time ultrasound guidance on complications of percutaneous dilatational tracheostomy: a propensity score analysis

Overview of attention for article published in Critical Care, December 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (76th percentile)
  • Good Attention Score compared to outputs of the same age and source (78th percentile)

Mentioned by

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10 tweeters
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2 Facebook pages

Citations

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26 Dimensions

Readers on

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78 Mendeley
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Title
Impact of real-time ultrasound guidance on complications of percutaneous dilatational tracheostomy: a propensity score analysis
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0924-7
Pubmed ID
Authors

Venkatakrishna Rajajee, Craig A Williamson, Brady T West

Abstract

Recent studies have demonstrated the feasibility of real-time ultrasound guidance (RUSG) during Percutaneous Dilatational Tracheostomy (PDT), including in patients with risk factors such as coagulopathy, cervical spine immobilization (CSI) and morbid obesity. Use of RUSG has been shown to improve the technical accuracy of PDT, however, it is unclear if there is an associated reduction in complications. Our objective was to determine whether the peri-procedural use of RUSG is associated with a reduction in complications of PDT using a propensity score analysis. This study reviewed all PDTs performed in a eight-year period in a neurocritical care unit. PDTs were typically performed by trainees under guidance of the attending intensivist. Bronchoscopic guidance was used for all procedures with addition of RUSG at the discretion of the attending physician. RUSG was used to guide endotracheal-tube withdrawal, guide tracheal puncture, identify guidewire entry level and confirm bilateral lung sliding. The primary outcome was a composite of previously defined complications including (among others) bleeding, infection, loss of airway, inability to complete procedure, need for revision, granuloma and early dislodgement. Propensity score analysis was used to ensure that the relationship of not using RUSG with the probability of an adverse outcome was examined within groups of patients having similar covariate profiles. Covariates included were age, gender, body mass index, diagnosis, APACHE-2 score, timing of tracheostomy, positive end-expiratory pressure and presence of risk factors including coagulopathy, CSI and prior tracheostomy. A total of 200 patients underwent PDT during the specified period, and 107 received RUSG. Risk factors for PDT were present in 63 (32%). There were 9 complications in the group without RUSG- bleeding (n = 4), need for revision related to inability to ventilate or dislodgement (n = 3) and symptomatic granuloma (n = 2). There was one complication in the RUSG group (early dislodgement). The odds of having an adverse outcome for patients receiving RUSG were significantly lower (OR 0.08, 95%CI 0.009-0.811, p = 0.032) than for those receiving a standard technique while holding the propensity score quartile fixed. The use of real time ultrasound guidance during percutaneous dilatational tracheostomy was associated with a significant reduction in procedure-related complications.

Twitter Demographics

The data shown below were collected from the profiles of 10 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 3%
India 1 1%
United States 1 1%
Unknown 74 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 13%
Other 9 12%
Student > Master 9 12%
Student > Ph. D. Student 8 10%
Student > Postgraduate 7 9%
Other 23 29%
Unknown 12 15%
Readers by discipline Count As %
Medicine and Dentistry 41 53%
Nursing and Health Professions 5 6%
Engineering 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Arts and Humanities 1 1%
Other 7 9%
Unknown 19 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 November 2015.
All research outputs
#4,166,745
of 20,534,453 outputs
Outputs from Critical Care
#2,812
of 5,720 outputs
Outputs of similar age
#54,966
of 243,232 outputs
Outputs of similar age from Critical Care
#8
of 32 outputs
Altmetric has tracked 20,534,453 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,720 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.2. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 243,232 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.