Comparison between single-step and balloon dilatational tracheostomy in intensive care unit: a single-centre,...

Area of Science:

• Intensive Care Medicine
• Surgical Techniques
• Respiratory Care

Background:

• Percutaneous dilatational tracheostomy (PDT) is a common procedure in intensive care units.
• The Ciaglia Blue Dolphin device is a modified technique for PDT.
• This study compares the Dolphin system to the established Ciaglia Blue Rhino technique.

Purpose of the Study:

• To compare the efficacy and safety of the Ciaglia Blue Dolphin technique versus the Ciaglia Blue Rhino technique for PDT in ICU patients.
• To evaluate procedure time, complications, and bleeding associated with each technique.

Main Methods:

• A randomized controlled trial was conducted with 70 ICU patients requiring PDT.
• Patients were assigned to either the Ciaglia Blue Rhino (n=35) or Ciaglia Blue Dolphin (n=35) technique.
• Outcomes assessed included tracheal puncture, tube placement time, complications, and bleeding.

Main Results:

• The Ciaglia Blue Rhino technique demonstrated a significantly shorter median procedure time (1.5 min) compared to the Ciaglia Blue Dolphin technique (4 min).
• Intra-tracheal bleeding after 6 hours was more frequent in the Dolphin group (68.6%) than the Rhino group (34.3%).
• No major bleeding events were reported in either group.

Conclusions:

• Both Ciaglia Blue Dolphin and Ciaglia Blue Rhino techniques are feasible for PDT in ICU patients.
• The Ciaglia Blue Rhino technique offers advantages with shorter procedure duration and potentially fewer tracheal injuries.
• Further research may explore refinements to the Dolphin technique to mitigate bleeding risks.