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Locally developed guidelines reduce immediate complications from percutaneous dilatational tracheostomy using the Ciaglia Blue Rhino Technique: A report on 200 procedures

Lookup NU author(s): Dr Graham Raftery, Dr Andrew Kilner, Dr David Ryan

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Abstract

Ciaglia Blue Rhino percutaneous dilatational tracheostomy is used as an aid to ventilatory weaning. It carries an immediate complication rate previously reported in 100 consecutive patients by Fikkers et al at 6% for "major" complications and 30% for "minor" complications. Mortality has been associated with the procedure. Our institution has performed dilatational percutaneous tracheostomy since 1998 and used the Blue Rhino technique since 2002. Consensus guidelines were developed following initial experiences. They focus on preoperative risk assessment including levels of ventilatory support and anatomical considerations, seniority of staff, use of bronchoscopy and capnography and correction of coagulopathies. Following introduction of the guidelines we conducted an audit of the first 200 Ciaglia Blue Rhino tracheostomies performed. There was an immediate major complication rate of 3% and minor complication rate of 18%. No deaths occurred within 24 hours of the procedure. We conclude that applying our consensus guidelines produced an immediate complication rate for Ciaglia Blue Rhino percutaneous dilatational tracheostomy below published audits.


Publication metadata

Author(s): Cosgrove JF, Sweenie A, Raftery G, Carey SM, Kilner AJ, Nesbitt ID, Cressey DM, Hirschauer N, Laws PG, Ryan DW

Publication type: Article

Publication status: Published

Journal: Anaesthesia and Intensive Care

Year: 2006

Volume: 34

Issue: 6

Pages: 782-786

ISSN (print): 0310-057X

ISSN (electronic): 1448-0271

Publisher: Australian Society of Anaesthetists Ltd


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