Tracheal tear and tension pneumothorax complicating bronchoscopy-guided percutaneous tracheostomy.
Percutaneous dilatational tracheostomy (PDT) is a frequently conducted procedure in critically ill patients. Bronchoscopic guidance of PDT is generally recommended to minimize the risk of unintentional tracheal injury. We present a case of tracheal tear and tension pneumothorax, a rare but potentially life-threatening complication, during continuously bronchoscopy-guided PDT. Sealing the large tracheal air fistula with the cuff of an endotracheal tube helped bridge time to definitive surgical repair in our patient. Bronchoscopic guidance may minimize, but cannot completely eliminate, the risk of tracheal injury during PDT.
Clinic of Intensive Care Medicine, University Hospital Bern, Inselspital, Switzerland.
Lukas
L
Brander
Jukka
J
Takala
D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D012421:Rupture; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging / Q000293:injuries*; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods