Percutaneous Dilatation Tracheostomy in the Critically Ill: Use of Ultrasound to Detect an Aberrant Course of the Brachiocephalic Trunk

Abstract

Percutaneous dilatation tracheostomy (PDT) is a commonly used procedure in intensive care units (ICUs).1 In general, it is associated with a relatively low rate of periprocedural complications.2 However, a number of adverse events are known including pneumothorax, tube dislocation, perforation of the posterior tracheal wall, and hemorrhage.3 To prevent their occurrence, safety measures are taken, including a clinical examination, diagnostic ultrasound, chest x-ray, thoracic computed tomography scan and magnetic resonance imaging before the procedure, and bronchoscopy during the procedure.