[Ballon dilatational tracheostomy. Technique and first clinical experience with the Ciaglia Blue Dolphin method]

Abstract

Background: Percutaneous dilatational tracheostomy (PDT) has become an established therapy for patients with prolonged intubation. It is of utmost importance for respiratory weaning of long-term ventilated patients in modern intensive care medicine. One attempt to bring PDT to perfection is a balloon dilatation technique that exerts mainly radial force to widen the tracheostoma.

Patients and methods: Twenty patients from a cardiosurgical intensive care unit underwent PDT with the new system. We analyzed the results based on the practical feasibility and possible complications from this balloon dilatation.

Results: Tracheostomy surgery lasted on average 3.3+/-1.9 min. It caused no bleeding requiring treatment nor injuries to the posterior tracheal wall. One fracture of a single tracheal cartilage ring was revealed, and one patient developed subcutaneous emphysema during the balloon dilatation. No wound infection was observed.

Conclusion: Balloon dilatational tracheostomy proved to be feasible, easy, and safe in the hands of experienced users. Its mainly radial force may reduce typical complications such as fracture of tracheal cartilage rings or injuries to the posterior tracheal wall.