Abstract
We read with interest the retrospective analysis of patients who underwent percutaneous tracheostomy by Fikkers and colleagues [1]. We were surprised by the high complication rates with both the guidewire dilating forceps (GWDF) technique and the Ciaglia Blue Rhino (CBR) technique in their series (25.1% and 41.5%, respectively). We prospectively collected data on perioperative complications of CBR from February 2000 to February 2003; in this period we performed 128 percutaneous dilating tracheostomies with the CBR technique. The complication rate was extremely low (Table (Table1).1). Although we must mention that we considered bleeding to have taken place only when blood loss was 'guesstimated' to be more than 20 ml, life-threatening blood loss or blood loss requiring surgical exploration was never encountered. Furthermore, we identified no complications related to needle insertion. Table 1 Perioperative complications of Ciaglia Blue Rhino Our complication rate is in accordance with those found in other series [2,3].
Highlights
We must mention that we considered bleeding to have taken place only when blood loss was ‘guesstimated’ to be more than 20 ml, lifethreatening blood loss or blood loss requiring surgical exploration was never encountered
We thank Dr Dongelmans and coworkers for their interest in our study. They state that they are surprised by our high complication rate and that their complication rate is in accordance with those found in other series, referring to just two studies
It is difficult to believe that the patients in those two series suffered only from major complications and not any minor ones! We prospectively collected all our data and found major complication rates of 7.6% with guidewire dilating forceps (GWDF) and 5.3% with Ciaglia Blue Rhino (CBR)
Summary
We read with interest the retrospective analysis of patients who underwent percutaneous tracheostomy by Fikkers and colleagues [1]. We were surprised by the high complication rates with both the guidewire dilating forceps (GWDF) technique and the Ciaglia Blue Rhino (CBR) technique in their series (25.1% and 41.5%, respectively). We prospectively collected data on perioperative complications of CBR from February 2000 to February 2003; in this period we performed 128 percutaneous dilating tracheostomies with the CBR technique. The complication rate was extremely low (Table 1). We identified no complications related to needle insertion. Our complication rate is in accordance with rates found in other series [2,3]
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