title: [Percutaneous tracheostomy through dilatation with the Ciaglia Blue Dolphin(®) method].
abstract: OBJECTIVE
  To describe the perioperative and postoperative complications in critically ill patients requiring percutaneous tracheostomy using the Ciaglia Blue Dolphin(®) technique.
  
  
  METHODS
  A prospective, observational, cohort study was carried out.
  
  
  METHODS
  Two medical-surgical Intensive Care Units.
  
  
  METHODS
  Adult patients subjected to prolonged mechanical ventilation.
  
  
  METHODS
  Percutaneous tracheostomy using Ciaglia Blue Dolphin(®) with an endoscopic guide.
  
  
  METHODS
  Demographic variables, intraoperative and postoperative complications, and Intensive Care Unit and ward mortality were recorded.
  
  
  RESULTS
  Seventy patients were included. Age: 68.6 ± 12 years (68.6% males). APACHE II score: 23.5±8.7. Duration of mechanical ventilation prior to percutaneous tracheostomy: 14.3 ± 5.5 days. Perioperative complications were recorded in 25 patients. In 23 of them the complications were mild: difficulty inserting the tracheostomy cannula (n=10), mild bleeding (n=7), partial atelectasis (n=3), cuff leak (n=2), and technical inability to complete the procedure (switch to Ciaglia Blue Rhino(®)) (n=1). Severe complications were recorded in 2 patients: severe bleeding that forced completion of the procedure via surgical tracheostomy (n=1), and false passage with desaturation (n=1). None of the complications proved life-threatening. Eleven complications occurred in the learning curve. As postoperative complications, mild peri-cannula bleeding was seen in 2 patients.
  
  
  CONCLUSIONS
  Percutaneous tracheostomy using the Ciaglia Blue Dolphin(®) technique with an endoscopic guide is a safe procedure. As with other procedures, the learning curve contributes to increase the incidence of complications. Potential benefits versus other percutaneous tracheostomy techniques should be explored by randomized trials.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: J B
authors.initials: JB
authors.lastname: Araujo
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España. Electronic address: jmaelizalde@gmail.com.
authors.forename: J M
authors.initials: JM
authors.lastname: Añón
authors.affiliation: Servicio de Medicina Intensiva, Hospital Santa Bárbara, Puertollano, Ciudad Real, España.
authors.forename: A M
authors.initials: AM
authors.lastname: García-Fernández
authors.affiliation: Servicio de Medicina Intensiva, Hospital Santa Bárbara, Puertollano, Ciudad Real, España.
authors.forename: M N
authors.initials: MN
authors.lastname: Parias
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: A
authors.initials: A
authors.lastname: Corrales
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: M O
authors.initials: MO
authors.lastname: Castro
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: E
authors.initials: E
authors.lastname: González-Higueras
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Pérez-Llorens
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Garijo
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: García de Lorenzo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness; D004106:Dilatation; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D013906:Thoracoscopy; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods*
keywords: Ciaglia Blue Dolphin(®); Complicaciones; Complications; Percutaneous dilatational tracheostomy; Percutaneous tracheostomy; Traqueotomía percutánea; Traqueotomía percutánea por dilatación