Simply modified percutaneous tracheostomy using the Cook® Ciaglia Blue Rhino™: a case series

Area of Science:

• Medical Procedures
• Surgical Techniques
• Patient Safety

Background:

• Percutaneous dilatational tracheostomy (PDT) traditionally uses a bronchoscope, which can interrupt ventilation.
• Modifications exist to perform PDT without a bronchoscope, but their safety and adoption are uncertain.

Purpose of the Study:

• To retrospectively evaluate the safety and efficacy of a simplified PDT technique using the Cook® Ciaglia Blue Rhino™ device without a bronchoscope.

Main Methods:

• A simplified PDT technique was performed in 186 patients, 2.0 cm below the cricothyroid membrane, using palpation for structure confirmation.
• Ultrasonography was employed only when palpation was challenging; blunt dissection was avoided.

Main Results:

• No PDT-related deaths occurred.
• Only three patients with coagulopathy experienced bleeding; no other early or late complications were observed.

Conclusions:

• The simplified PDT technique is safe and effective.
• This method is particularly useful in settings with limited equipment and personnel.