SynthesisBMC anesthesiology2026
Percutaneous dilatational tracheostomy with versus without bronchoscopic guidance: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- To guide or not to guide percutaneous dilational tracheostomy? broncoscope, ultrasound or nothing?Critical care (London, England) · 2026Article
- Is less always more? Reframing the role of bronchoscopy during percutaneous dilatational tracheostomy.Critical care (London, England) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
backgroundPercutaneous dilatational tracheostomy (PDT) is a critical intervention for patients with respiratory failure. However, the value of bronchoscopic guidance during PDT remains clinically debated. We conducted a systematic review and meta-analysis to evaluate the role of bronchoscopy during PDT by assessing its impact on complication rates and other clinically relevant outcomes.
methodsA systematic search was conducted in PubMed, Embase, the Cochrane library and Web of Science. Randomized controlled trials (RCTs) comparing PDT performed with versus without bronchoscopic guidance were included. The risk of bias of the RCTs was rated using the revised Cochrane risk of bias, version 2 tool (RoB 2) and the certainty of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The primary outcomes were complications including bleeding, misplacement (paratracheal placement of the tube), and posterior tracheal wall injury. The secondary outcomes included operating time and first-attempt success of tracheal puncture. Pooled effect estimates were calculated using risk ratios for dichotomous outcomes and mean differences for continuous outcomes, with 95% confidence intervals.
resultsSeven studies (n = 639 patients) were included. The bronchoscopic guidance group showed reduced incidence of bleeding (RR 0.57, 95% CI, 0.37 to 0.88), misplacement (RR 0.17, 95% CI, 0.06 to 0.49), and posterior tracheal wall injury (RR 0.08, 95% CI, 0.02 to 0.32) compared to the non-bronchoscopic group with moderate-certainty evidence. Additionally, the bronchoscopic guidance group had a higher first-attempt success rate of tracheal puncture (RR 1.33, 95% CI, 1.21 to 1.46, high-certainty evidence). No significant difference in operating time was found between the two groups (MD 1.14, 95% CI, -1.52 to 3.79, very low-certainty evidence).
conclusionCompared with the non-bronchoscopic method, bronchoscopic guidance during PDT may improve procedural safety and efficacy. However, high-quality, larger RCTs are required to draw more definitive conclusions.
trial registrationPROSPERO (registration number: CRD42024508516).
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Registered trials
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