• Christian Byhahn, Klaus Westphal, Dirk Meininger, Britta Gürke, Paul Kessler, and Volker Lischke.
• Department of Anesthesiology, Intensive Care Medicine, and Pain Control, J.W. Goethe University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. c.byhahn@em.uni-frankfurt.de
• Intensive Care Med. 2002 Sep 1;28(9):1262-6.

ObjectiveTo compare two single-dilator percutaneous tracheostomy techniques, Ciaglia Blue Rhino and the new PercuTwist technique.Design And SettingRandomized, observational clinical trial in patients undergoing elective percutaneous tracheostomy in the intensive care units of a university hospital.PatientsSeventy consecutive, adult patients undergoing either Blue Rhino ( n=35) or PercuTwist tracheostomy ( n=35).InterventionsPerformance of percutaneous tracheostomy with a novel screwlike dilating device (PercuTwist) or conically shaped, flexible rubber dilator (Blue Rhino).ResultsStoma dilation was successful with the respective device in all patients. While subsequent tracheostomy cannula insertion was uneventful in all but one patients undergoing the Blue Rhino technique, it was difficult or even impossible in eight patients who underwent PercuTwist tracheostomy. Regarding serious and intermediate procedural-related complications, two cases of posterior tracheal wall injury occurred with the PercuTwist technique. No serious or intermediate complications were noted during Blue Rhino tracheostomy. There was no statistical significance between the two techniques in terms of minor and overall complications.ConclusionsSo far the new PercuTwist technique represents an alternative to the established Blue Rhino technique. Nonetheless, the two cases of posterior tracheal wall injury should not be underestimated, on the one hand, but, on the other, may be attributed to a learning curve with a new technique. The new PercuTwist technique should be performed by various teams and in a considerably larger numbers of patients before an ultimate rating can be made.

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