• J B Araujo, J M Añón, A M García-Fernández, M N Parias, A Corrales, M O Castro, E González-Higueras, J C Pérez-Llorens, M A Garijo, and A García de Lorenzo.
• Servicio de Medicina Intensiva, Hospital Virgen de la Luz, Cuenca, España.
• Med Intensiva. 2015 Mar 1; 39 (2): 76-83.

ObjectiveTo describe the perioperative and postoperative complications in critically ill patients requiring percutaneous tracheostomy using the Ciaglia Blue Dolphin(®) technique.DesignA prospective, observational, cohort study was carried out.ScopeTwo medical-surgical Intensive Care Units.PatientsAdult patients subjected to prolonged mechanical ventilation.InterventionPercutaneous tracheostomy using Ciaglia Blue Dolphin(®) with an endoscopic guide.VariablesDemographic variables, intraoperative and postoperative complications, and Intensive Care Unit and ward mortality were recorded.ResultsSeventy 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.ConclusionsPercutaneous 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.Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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