The impact of bronchoscopy on the safety of percutaneous tracheostomy: a randomized controlled trial
Authors' conclusion
Bronchoscopy during PCT does not reduce major complications or mortality, but increases procedure time, complexity, and costs.
Study context
- Population
- Mechanically ventilated adults requiring percutaneous dilational tracheostomy (PCT), 2016–2024
- Participants
- 307 participants
- Comparison
- PCT with vs without bronchoscopic guidance
- Bronchoscopyn = 154
- Non bronchoscopyn = 153reference
- Primary endpoint
- Composite of:
- Procedure-related complications
- Classified as minor (e.g., bleeding, desaturation)
- Major (e.g., airway loss, tracheal rupture, severe pneumothorax, major bleeding requiring transfusion and death)
- Follow-up
- 24 hours
Methodological detailsprospective
- Prospective
Primary result
As reported in the abstract
Minor complications (particularly intra-procedural hypertension)
P = 0.005
- Major complication rates identical in both groups
- 5.2%
Secondary outcomes
Procedure duration
- Mean procedure duration longer with bronchoscopy: 5.46 vs 4.17 minutes
- P = 0.003
Hospital LOS
- No significant difference: 40.5 ± 48.7 days vs 38.9 ± 33.1 days
- P = 0.73
30-day mortality
- No significant difference: 24.8% vs 26.6%
- P = 0.72
24-hour mortality
- No significant difference: 1% for both
Original publication
The impact of bronchoscopy on the safety of percutaneous tracheostomy: a randomized controlled trial. Crit Care. Published 18 March 2026. doi:10.
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