Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 20 , ISSUE 3 ( 2016 ) > List of Articles


Inadvertent migration of guidewire into Murphy′s eye of endotracheal tube during percutaneous dilatational tracheostomy

Binita Panigrahi, Devi Prasad Samaddar, Tushar Kumar

Keywords : Complications, guidewire, impaction, percutaneous tracheostomy

Citation Information : 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):188-190.

DOI: 10.4103/0972-5229.178186

License: CC BY-ND 3.0

Published Online: 01-10-2013

Copyright Statement:  Copyright © 2016; The Author(s).


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.

PDF Share
  1. Hill SA. An unusual complication of percutaneous tracheostomy. Anaesthesia 1995;50:469-70.
  2. Toy FJ, Weinstein JD. A percutaneous tracheostomy device. Surgery 1969;65:384-9.
  3. Kornblith LZ, Burlew CC, Moore EE, Haenel JB, Kashuk JL, Biffl WL, et al. One thousand bedside percutaneous tracheostomies in the surgical intensive care unit: Time to change the gold standard. J Am Coll Surg 2011;212:163-70.
  4. Ferraro F, Marullo L, d′Elia A, Izzo G. Elective tracheostomy in intensive care unit: Looking between techniques, a three cases report. Indian J Anaesth 2014;58:190-2.
  5. McCormick B, Manara AR. Mortality from percutaneous dilatational tracheostomy. A report of three cases. Anaesthesia 2005;60:490-5.
  6. Arunkumar AS, Vydhyanadhan T, Ravikumar A, Kamat V. An unusual complication of percutaneous dilatational tracheostomy. Indian J Crit Care Med 2004;8:40-2.
  7. Siranovic M, Gopcevic S, Kelecic M, Kovac N, Kriksik V, Rode B, et al. Early complications of percutaneous tracheostomy using the Griggs method. Signa Vitae 2007;2:18-20.
  8. Barba CA, Angood PB, Kauder DR, Latenser B, Martin K, McGonigal MD, et al. Bronchoscopic guidance makes percutaneous tracheostomy a safe, cost-effective, and easy-to-teach procedure. Surgery 1995;118:879-83.
  9. Powell DM, Price PD, Forrest LA. Review of percutaneous tracheostomy. Laryngoscope 1998;108:170-7.
  10. Vargas M, Sutherasan Y, Antonelli M, Brunetti I, Corcione A, Laffey JG, et al. Tracheostomy procedures in the intensive care unit: An international survey. Crit Care 2015;19:291.
  11. Bouvette M, Fuhrman TM. Preventing complications during percutaneous tracheostomy. Anesthesiology 1999;90:918-9.
  12. Kleine-Brueggeney M, Greif R, Ross S, Eichenberger U, Moriggl B, Arnold A, et al. Ultrasound-guided percutaneous tracheal puncture: A computer-tomographic controlled study in cadavers. Br J Anaesth 2011;106:738-42.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.