Percutaneous tracheostomy: Ciaglia Blue Rhino vs basic Ciaglia

Introduction

The percutaneous tracheotomy first described by Ciaglia in 1985 has been widely used since, showing it to be fast, safe and easy to perform.

In 1999 a new method arose, the Ciaglia Blue Rhino, which was done only by one person (hydrophilic dilatator). We compare the two procedures in our services.

Objective

Registration of our experience with percutaneous tracheotomy, and a comparison between two procedures.

Methods

From January 1997 to December 2001 we used the basic Ciaglia and the Ciaglia Blue Rhino as the chosen methods of tracheotomy. We had 184 patients; in 108 patients the basic Ciaglia was used, and in 76 the Ciaglia Rhyno Blue.

There were no statistical differences with regards to sex, age, Acute Physiology and Chronic Health Evaluation II, but we had different results in the duration of procedure, the length of cannula that we can apply, and complications:

• Cannula > 8.0 mm: Rhino Blue, 70 patients; basic Ciaglia, four patients (P < 0.0001).

• Procedure that takes > 6 min: Rhino Blue, two patients; basic Ciaglia, 94 patients (P < 0.0001).

• Complications: Rhino Blue, 14 patients; basic Ciaglia, 38 patients (P < 0.02).

Conclusion

When a skilled physician performs a percutaneous tracheotomy guided by bronchoscopy it is a safe method with a low risk of complication. Ciaglia Blue Rhino is a faster procedure, with a lower number of complications. In addition to this we can introduce a wider cannula; therefore it is safer. In our service it is the method of choice for tracheotomy.