title: A new endotracheal tube designed to enable a single operator to perform percutaneous dilatational tracheostomy while maintaining the airway, providing continuous bronchoscopic guidance, and minimizing procedural complications: demonstration of feasibility on a mannequin and a cadaver.
abstract: BACKGROUND
  : We designed a double-lumen endotracheal tube (the EZ [Easy] Tracheostomy [EZT]) to enable a single operator to safely perform percutaneous dilatational tracheostomy (PDT) at the bedside while providing continuous bronchoscopic guidance. The EZT design also aims to ensure uninterrupted mechanical ventilation during most of the PDT procedure via a secure airway. It aims to significantly minimize hypoxia, hypoventilation, auto-positive end-expiratory pressure, airway loss, posterior wall laceration, and damage to the endoscope related to the current methodology.
  
  
  METHODS
  : We demonstrated the feasibility of our method on a mannequin model and a cadaver.
  
  
  RESULTS
  : Single operators successfully performed the modified PDT on their first attempt with excellent visualization and no obvious complications. The potential for minimal interruption in ventilation, low risk of airway loss or malpositioning, and significant reduction in other PDT-related complications were clearly demonstrated. The procedure was found to be easier to perform when compared with conventional PDT.
  
  
  CONCLUSIONS
  : It is feasible for a single operator to perform PDT with continuous bronchoscopic guidance when using the EZT on cadaver and mannequin models. Clinical studies are warranted to evaluate this new tool.
authors.affiliation: *Department of Pulmonary and Critical Care Medicine, Tulane University Health Science Center †Department of Anesthesiology, Tulane University, New Orleans, LA.
authors.forename: Yashvir Singh
authors.initials: YS
authors.lastname: Sangwan
authors.forename: Joseph
authors.initials: J
authors.lastname: Koveleskie
authors.forename: Jaime
authors.initials: J
authors.lastname: Palomino
authors.forename: Francesco
authors.initials: F
authors.lastname: Simeone