Balloon dilatational tracheostomy: initial experience with the Ciaglia Blue Dolphin method

Area of Science:

• Cardiothoracic Surgery
• Intensive Care Medicine
• Respiratory Medicine

Background:

• Percutaneous dilational tracheostomy (PDT) is standard for prolonged intubation.
• A novel balloon dilation PDT technique, the Ciaglia Blue Dolphin system, was evaluated.
• This system utilizes radial force to create the tracheostoma.

Purpose of the Study:

• To assess the clinical feasibility of the Ciaglia Blue Dolphin system for PDT.
• To identify and analyze any complications associated with this balloon dilation technique.

Main Methods:

• Initial clinical experience with 20 patients in a cardiosurgical intensive care unit.
• Evaluation of practical feasibility and complication rates.
• Analysis of outcomes based on skin incision length.

Main Results:

• Average surgery time was 3.3 minutes.
• No treatment-requiring bleeding or posterior tracheal wall injuries occurred.
• One case of tracheal cartilage fracture (5%) and one of spontaneous subcutaneous emphysema were noted.

Conclusions:

• Balloon dilational tracheostomy with the Ciaglia Blue Dolphin system is feasible, easy, and successful.
• The radial force mechanism may decrease risks of cartilage fracture and posterior tracheal wall injury.
• The technique demonstrated a favorable safety profile with minimal complications.