Pneumothorax following percutaneous dilatational tracheostomy

Objective: To examine reasons for pneumothorax following percutaneous tracheostomy. Design: Retrospective analysis. Setting: Neurological intensive care unit at a university hospital. Patients: Two of 28 patients undergoing percutaneous tracheostomy between February 1995 and June 1997. Interventions: Percutaneous dilatational tracheostomy (PDT) using the Ciaglia technique. Results: Both patients had an apical pneumothorax post-tracheostomy, which remained clinically asymptomatic and underwent resorption within three to five days. Conclusions: The data presented corroborate the assumption that pulmonary barotrauma following obstruction of the endotracheal tube with a fibreoptic bronchoscope during PDT is a possible aetiological explanation for the pneumothorax.