Comparative Clinical Trial between Ciaglia and Griggs Techniques during Tracheostomy Performed in Patients Admitted to Intensive Care Unit

Abstract

Percutaneous dilatation tracheostomy (PDT) is one of the most frequent interventions in ventilator dependant ICU patients. Ciaglia and Griggs are two common PDT techniques. Few studies are available comparing these two methods, but there is no data available to compare these two techniques in Iranian population. The aim of this study was to compare Ciaglia and Griggs technique in our population in order to recognize advantages and disadvantages of each technique in order to identify the most beneficial one. This study is a comparative clinical trial conducted on 100 consecutive ICU admitted patients who needed prolonged intubation; half of them underwent PDT with Ciaglia method and other half with Griggs method. Procedural time and short term complications including bleeding, vital signs instability and technical errors were compared in both two methods. Both groups were comparable in demographic characteristics. Griggs method performed significantly faster than Ciaglia method (P=0.001). Complications such as high grade bleeding (P=0.01) and cardiac dysrhythmias (P=0.07) were less in Ciaglia technique than Griggs. Skin incision smaller than required was reported more with Griggs method than Ciaglia (P=0.03). We conclude that PDT with Ciaglia method is safer with less complications than the Griggs method. We suggest use of Ciaglia for less experienced operators.