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

Abstract

When first introduced, percutaneous dilatational tracheostomy (PDT) was performed using a bronchoscope. The bronchoscope itself, however, has several disadvantages, including interruption of ventilation. Modifications of the standard PDT technique have suggested that PDT can be safely performed without a bronchoscope. However, the safety of these modifications is unclear and many modifications have yet to be widely adopted. This study retrospectively evaluated the safety of a simplified PDT technique using the Cook® Ciaglia Blue Rhino™ in 186 patients. After confirming the underlying structures by palpation, PDT was performed without a bronchoscope or blunt dissection, 2.0 cm below the cricothyroid membrane. Ultrasonography was used only when palpation was difficult. Except for bleeding in three patients with coagulopathy, none of the patients experienced any early or late complications, and there were no deaths related to PDT. These findings confirm that PDT can be safely performed using a simplified technique, which may be useful in situations with limited equipment and medical personnel.

Fiber-optic Bronchoscope-guided vs Mini-surgical Technique of Percutaneous Dilatational Tracheostomy in Intensive Care Units

“…Some of the researchers have mentioned that more than 250 mL of bleeding during PCDT should be regarded as severe bleeding. 15 In our study, mean blood loss in group-M was lesser than the FOB-guided group but it was not clinically significant [although statistically significant ( p = 0.001)]. Maximum bleeding documented in our study was 15 mL in both the study groups.…”

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits

“…PDT was performed using Ciaglia Blue Rhino ™ [4] ; the technique is herein described. Firstly, cannula's cuff capacity is checked to reduce the risk of cuff's rupture.…”

Identifying the ideal tracheostomy site based on patient characteristics during percutaneous dilatational tracheostomy without bronchoscopy

“…We previously reported that PDT was safely performed 2 cm below the cricothyroid membrane without bronchoscopy in 186 patients by confirming the underlying structures through palpation [10]. Although this simplified method is convenient and does not require sophisticated equipment, its biggest drawback was the inability to confirm the precise location for PDT, which is critical when performing PDT [11,12].…”