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Acta clinica Croatica, Vol. 55. No. Supplement 1, 2016.

Other

https://doi.org/10.20471/acc.2016.55.s1.15

Bilateral Pneumothorax as a Complication of Percutaneous Tracheostomy: Case Report

Tino Klancir ; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb
Višnja Nesek Adam orcid id orcid.org/0000-0002-6521-4136 ; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb; Osijek School of Medicine, Josip Juraj Strossmayer University, Osijek
Viviana Mršić ; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb
Damjan Marin ; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb
Tatjana Goranović ; Osijek School of Medicine, Josip Juraj Strossmayer University, OsijekDepartment of Anesthesiology and Intensive Medicine, University Department for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia

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Abstract

Percutaneous dilatational tracheostomy is a common surgical procedure that is becoming the method of choice in critically ill patients whenever prolonged airway secure and/ or ventilation support is needed. Although adverse events are relatively uncommon, serious life threatening complications can arise from this bedside procedure. We report a case of a 70-year-old female who developed extensive subcutaneous emphysema and bilateral pneumothorax immediately after a percutaneous dilatational tracheostomy procedure. Different mechanisms, such as damage to posterior or anterior tracheal wall, false passage or paratracheal placement or dislocation of the cannula are considered to be responsible for the development of pneumothorax and subcutaneous emphysema. Although bronchoscopic control after the tracheostomy procedure did not reveal any tracheal injury, we believe that subcutaneous emphysema and bilateral pneumothorax are most likely caused by procedure induced injuries of the trachea in addition to the applied high airway pressure induced by excessive or inappropriate ventilation. In our case report, we would like to emphasize that continuous bronchoscopic guidance during percutaneous tracheostomy is invaluable in decreasing the incidence of its overall complications, especially during enhancing the team experience.

Keywords

Tracheostomy- Methods; Acute Disease; Pneumothorax; Subcutaneous Emphysema; Case Reports

Hrčak ID:

155053

URI

https://hrcak.srce.hr/155053

Publication date:

1.3.2016.

Article data in other languages: croatian

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