Archives of Anesthesiology and Critical Care 2017. 3(4):400-402.

Complication of Intraoperative Percutaneous Dilatational Tracheostomy without Bronchoscopy: A Case Report
Parviz Amri Maleh, Fatemeh Damavandi, Fatemeh Heidarnia


A 72-year-old woman who was a candidate for percutaneous dilatational tracheostomy (PDT) using the Ciaglia Blue Rhino single dilator was examined. After dilation, a stoma was created on the guide wire, but the dilator could hardly pass through and pulled in the endotracheal tube with it. Bronchoscopy was therefore performed. The guide wire that was inside the Murphy eye of the endotracheal tube was then removed. So the dilator and guide wire was removed. The endotracheal tube was pulled back slightly and the tracheostomy tube was inserted once again. Fiberoptic bronchoscopy is recommended in cases of a problematic anatomy or when the PDT tube placement is suspicious.


percutaneous dilatational tracheostomy; murphy eye; bronchoscopy; intraoperative complication

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Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest. 1985; 87(6):715-9.

Saritas A, Saritas PU, Kurnaz MM, Beyaz SG, Ergonenc T. The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice. J Pak Med Assoc. 2016; 66(1):83-9.

Massick DD, Yao S, Powell DM, Griesen D, Hobgood T, Allen JN, et al. Bedside tracheostomy in the intensive care unit: a prospective randomized trial comparing open surgical tracheostomy with endoscopically guided percutaneous dilational tracheotomy. Laryngoscope. 2001; 111(3):494-500.

Johnson‐Obaseki S, Veljkovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients. Laryngoscope. 2016; 126(11):2459-67.

Lother A, Wengenmayer T, Benk C, Bode C, Staudacher DL. Fatal air embolism as complication of percutaneous dilatational tracheostomy on venovenous extracorporeal membrane oxygenation, two case reports. J Cardiothorac Surg. 2016; 11(1):102.

Panigrahi B, Samaddar DP, Kumar T. Inadvertent migration of guidewire into Murphy's eye of endotracheal tube during percutaneous dilatational tracheostomy. Indian J Crit Care Med. 2016; 20(3): 188-90.

Hashemian SM-R, Digaleh H. A Prospective Randomized Study Comparing Mini-surgical Percutaneous Dilatational Tracheostomy With Surgical and Classical Percutaneous Tracheostomy: A New Method Beyond Contraindications. Medicine. 2015; 94(47):e2015.

Klancir T, Adam VN, Mrsic V, Marin D, Goranovic T. Bilateral pneumothorax as a complication of percutaneous tracheostomy: case report. Acta Clin Croat. 2016; 55 Suppl 1:98-102.

Brahmbhatt PA, Modi FD, Roy TM, Byrd RP Jr. Common carotid artery laceration and innominate artery pseudo-aneurysm following a percutaneous dilatational tracheostomy attempt. Respir Care. 2014; 59(10):e153-5.

Sangwan YS, Chasse R. A modified technique for percutaneous dilatational tracheostomy: A retrospective review of 60 cases. J Crit Care. 2016; 31(1):144-9.

Chung W, Kim BM, Park SI. Simply modified percutaneous tracheostomy using the Cook(R) Ciaglia Blue Rhino: a case series. Korean J Anesthesiol. 2016; 69(3): 301-4.

Umutoglu T, Bakan M, Topuz U, Yilmaz S, Idin K, Alver S, et al. Comparison of EtView tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy. J Clin Monit Comput. 2016; 31(3):507-512.

Dubey PK, Sanjeev OP. Keep an eye on Murphy's eye during percutaneous dilatational tracheostomy. Indian Journal of Critical Care Medicine. 2016; 20(6):379-80.

Pattnaik SK, Ray B. Procedural improvisation to prevent guidewire kinking in Griggs percutaneous tracheostomy without bronchoscopic guidance. Indian J Crit Care Med. 2016; 20(6):378-9.

Pattnaik SK, Ray B, Sinha S. Griggs percutaneous tracheostomy without bronchoscopic guidance is a safe method: A case series of 300 patients in a tertiary care Intensive Care Unit. Indian J Crit Care Med. 2014; 18(12):778-82.


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