Percutaneous Gastrostomy and Percutaneous Bedside Tracheostomy

Percutaneous bedside tracheostomy (PBT) is a minimally invasive procedure that involves inserting a tracheostomy tube, often with the use of ultrasound technology. PBT can be performed quickly and safely by a trained ICU team, led by a critical care physician, and does not require the use of the operating room facilities.

Ultrasound Increases Safety

A 2014 article published in Critical Care Research and Practice described percutaneous bedside tracheostomy as “one of the common and safe procedures in intensive care units through the world.” This procedure has been demonstrated to be just as safe as the conventional surgical approach in the majority of critically ill patients. 

In addition, a 2015 article published in Critical Care found that ultrasound improved patient outcomes in percutaneous bedside tracheostomy procedures. “Another advantage of pre-procedure [ultrasound] of the neck is that it allows the identification of vulnerable structures, such as blood vessels and the thyroid gland, in the neck prior to [the procedure],” the study explained. “Moreover, real-time [ultrasound] performed during the procedure plays a major role in revealing potentially aberrant vessels, which allows needles and dilators to be guided away from at-risk structures, thus avoiding immediate vascular complications.”

PUMA-G and Ultrasound Technology

PUMA-G uses the same ultrasound technology as percutaneous bedside tracheostomy, moving the percutaneous endoscopic gastrostomy from the operating suite to the ICU patient’s bedside. 

Current procedures to insert gastrostomy tubes require expensive, inpatient hospital equipment and have complication rates that can run as high as 20 percent. In addition, the need for highly trained surgeons, operating room time and use of specialized equipment, including endoscopes, fluoroscopes and Computed Tomography (CT) scanners translates into higher costs, longer patient wait times and additional hospital admission costs.  

Invented by Dr. Steven Tropello, a critical care physician who was frustrated by the inefficiency of the current system, PUMA offers a single-use platform technology combining catheters, magnets, and low-cost, point-of-care ultrasound for visual feedback in diagnostic, interventional and therapeutic procedures.  

PUMA-G technology is expected to undergo FDA review in June 2018 and to be available on the market in Fall 2018.

If you’d like to be an early adopter of PUMA-G technology, please sign up for CoapTech’s Early Adopter program today. 

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