Percutaneous tracheostomy is a bedside procedure performed in critically ill, intubated patients requiring prolonged mechanical ventilation. Bronchoscopic guidance during PDT enhances safety and accuracy, allowing direct visualization of tracheal structures and reducing the risk of posterior wall injury.
Prolonged mechanical ventilation (>7–10 days expected)
Airway protection in neurologically impaired patients
Pulmonary toilet in patients with poor secretion clearance
Facilitating weaning from mechanical ventilation
Bronchoscopic guidance increases safety of PDT by allowing real-time visualization.
Ideal puncture site: Between 2nd–3rd or 3rd–4th tracheal rings.
Careful coordination between bronchoscopist and proceduralist is essential.
Always confirm tube placement and check for complications post-procedure.