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Experimental comparison of Ciaglia and Griggs PCT techniques with biomechanical method: A-602

Rozin, I.; Coitoru, M.; Badaev, F.; Altman, N.; Teitelman, U.; Altman, E.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 157–158
Intensive Care Medicine
Free

Department of General Surgery, Puria Hospital, Tveria, Israel

Background and Goal of Study: To create a method for biomechanical experimental evaluation of percutaneous tracheostomy (PCT). Nowadays two techniques of PCT (Ciaglia and Griggs) are employed. Every technique is based on gradual tearing of the hole in the cervical trachea by specially designed dilators. Biomechanical study of the different stages of PCT will help to compare the course of these two procedures.

Materials and Methods: PCT by Ciaglia technique (n = 10) and by Griggs technique (n = 10) were performed on fresh dead pigs with mass of the body 115 ± 3 kg. Portex set of instruments was used for Griggs technique and Cook set of instruments - for Ciaglia technique. During different stages of PCT (piercing, penetrating, pulling, and pushing) special measurements of forces applied on different instruments were performed with the help of electronic dynamometer (MRC). Calculations of energy spent for these stages of PCT were done. At the end of experiments evaluation of the cervical trachea was performed to receive objective parameters of each tracheotomy.

Results and Discussions: Application of Ciaglia dilator requested more energy (1.54 times) than Griggs dilating forceps (p < 0.05). Formation of tracheotomy by Ciaglia dilator was more exact than by Griggs forceps due to special markings on the dilator. The work with Griggs dilating forceps requested additionally experience due to absence of any markings on the dilator. Laceration of the cervical trachea could be easily happened in the time of work with dilating forceps in Griggs technique and during insertion of tracheostomy tube loaded on dilator in Ciaglia technique. Macroscopic appearance and parameters of each tracheostomy type were the same (p < 0.05).

Conclusion(s): PCT by these two techniques has almost similar biomechanical characteristics. In spite of difference in the design of dilators the final result of the two techniques is the same. Both techniques have some dangerous moments. In order to prevent them several improvements must be done in instrumentation.

© 2005 European Society of Anaesthesiology