Ciaglia Blue Rhino: A modified technique of percutaneous dilatational tracheostomy. Technique and early results

Safety and Feasibility of Percutaneous Tracheostomy Performed by Neurointensivists

“…All patients were paralyzed for the procedure with vecuronium or cisatricurium. Percutaneous dilational tracheostomy was performed through a 1.5-cm transverse incision at the second of third cartilaginous interspace using a modification [23] of the procedure initially described by Ciaglia et al [24], with the Cook Ciaglia Blue Rhino PT kit. Because of concern for hypoventilation and elevated ICP [13,[17][18][19] associated with bronchoscopy, capnography was routinely used to verify tracheal positioning of the tube [25], with bronchoscopy available for evaluation of the airway or tracheostomy placement, if necessary.…”

Safety and practicability of percutaneous translaryngeal tracheotomy (Fantoni technique) in surgery of maxillofacial and oropharyngeal tumours – Own results and review of the literature

“…Firstly, throughout the pull-through phase, optimum oxygenation is ensured by the special tube provided (ID 5 mm). Secondly, a forced, extremely rapid procedure such as that sometimes reported for the Blue Rhino technique with a puncture time of less than 3 min (Byhahn et al, 2000a) represents a relative increase in risk for the patient. With systematic use of continuous laryngoscopic visualisation of tracheal tube positioning, including the turning process, the total TLT time can, however, be shortened slightly.…”

“…The first percutaneous technique to be used worldwide, described by Ciaglia et al (1985), is based on the principle of tracheal puncture followed by dilatation of the soft tissues of the neck and insertion of the tracheal tube using the Seldinger technique (Seldinger, 1953). Four more methods, according to Griggs et al (1990), Fantoni and Ripamonti (1997), Frova and Quintel (2002), and the Ciaglia Blue Rhino technique (Byhahn et al, 2000a) are currently available in addition to the Ciaglia method for percutaneous tracheotomy. All these techniques basically follow the same principle: namely continuous bronchoscopic visualisation of the puncture/dilatation process is always an absolute prerequisite (Marelli et al, 1990;Poldermann et al, 2003;Byhahn et al, 2005b).…”

PercuTwist-Dilatationstracheotomie

“…In den folgenden Jahren wurden weitere Dilatationsverfahren beschrieben: die Zangenspreizungsverfahren nach Schachner und Griggs (GWDF) [10,14]; hierbei fand Letztere die breitere Anwendung, die translaryngeale Tracheotomie nach Fantoni (TLT) [7] und die Ciaglia Blue Rhino (CBR)-Methode [2,3].In einer Metaanalyse von Dulguerov et alzeigte sich beim Vergleich zwischen chirurgischer und perkutaner Tracheotomie (Daten bis 1996) eine höhere Rate perioperativer Komplikationen (3% vs. 10%) bei den perkutanen Verfahren [6].…”