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


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.


CONCLUSIONS
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.
Gromann
T W
TW
Klinik für Herz-, Thorax- und Gefässchirurgie, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, Germany. gromann@dhzb.de
Birkelbach
O
O
Hetzer
R
R
D000368:Aged; D001999:Bronchoscopy; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013352:Subcutaneous Emphysema / Q000209:etiology; D014132:Trachea / Q000293:injuries; D014140:Tracheotomy / Q000295:instrumentation / Q000379:methods*; D015300:Ventilator Weaning