Panigrahi Binita, Samaddar Devi Prasad, Kumar Tushar
Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Indian J Crit Care Med. 2016 Mar;20(3):188-90. doi: 10.4103/0972-5229.178186.
Percutaneous dilatational tracheostomy is a commonly performed bedside procedure in the Intensive Care Unit. Although serious and fatal complications have been reported, the procedure is by and large safe to perform in experienced hands. We report here an innocuous problem encountered twice. After the guidewire insertion and dilatation, subsequent railroading became difficult owing to migration of guidewire into the Murphy's eye of the endotracheal tube (ETT). Awareness about this possibility can avert inadvertent delays and complications during the procedure. A tug or gentle pulling of ETT after insertion of the guidewire rules out an impaction in the eye or other part of the ETT.
经皮扩张气管切开术是重症监护病房中常见的床边操作。尽管已有严重和致命并发症的报道，但在经验丰富的操作人员手中，该操作总体上是安全的。我们在此报告一个两次遇到的无害问题。在插入导丝并进行扩张后，由于导丝移入气管内导管（ETT）的墨菲眼，随后的置入变得困难。了解这种可能性可以避免操作过程中出现意外延误和并发症。在插入导丝后对ETT进行轻拉或轻柔牵引，可排除在ETT眼或其他部位的嵌塞情况。
