SynthesisFrontiers in medicine2026
Ultrasound-guided percutaneous dilatational tracheostomy versus landmark- and bronchoscopy-guided techniques in critically ill patients: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Is less always more? Reframing the role of bronchoscopy during percutaneous dilatational tracheostomy.Critical care (London, England) · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Percutaneous dilatational tracheostomy (PDT) is widely performed in critically ill patients. In contemporary intensive care units (ICUs), multimodal image-guided PDT (particularly the combination of ultrasound and bronchoscopy) is increasingly advocated to maximize procedural safety. However, randomized data comparing single-modality guidance strategies remain clinically relevant, especially where one modality is unavailable. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ultrasound-guided PDT with anatomical landmark-guided PDT or bronchoscopy-guided PDT. Four databases were searched from inception to February 16, 2026. Primary outcome was overall procedural complication rate. Secondary outcomes included first-attempt success rate, bleeding events, and procedure time. Random-effects models were used to pool risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Results: A total of 11 RCTs (1,035 patients) were included. Compared with other percutaneous PDT techniques, ultrasound-guided PDT significantly reduced the risk of overall procedural complications (RR 0.56, 95% CI 0.46 to 0.69, Conclusion: In critically ill adults undergoing percutaneous tracheostomy, ultrasound guidance is associated with higher first-attempt success, lower risks of overall complications and bleeding, without prolonging procedure duration. These findings support ultrasound-guided PDT as a preferred percutaneous approach. Nevertheless, these findings should be interpreted within modern practice, where combined ultrasound plus bronchoscopy is often considered the preferred safety strategy in well-equipped ICUs, particularly for high-risk anatomy and re-intervention cases. Systematic review registration: https://osf.io/7wgzu, identifier.
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