Asphyxia caused by delayed subglottic stenosis after neck trauma

Shen, Yueyao; Li, Kai; Chen, Peng; Yu, Youjia; Chen, Feng

doi:10.1007/s12024-021-00391-z

Cited by 3 publications

(3 citation statements)

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“…Найпоширенішою причиною порушень вентиляції дихальних шляхів є травма, яка може бути наслідком тривалої ендотрахеальної інтубації, хірургічних втручань, травми шиї або вроджена патологія. Зменшення просвіту трахеї понад 40% призводить до тяжких наслідків, в тому числі гіпоксії тканин [1,2]. Через вплив цього патогенетичного чинника у новонароджених можуть виникнути проблеми з розвитком ускладнень і захворювань легень і ЦНС [3].…”

Section: вступunclassified

Impact of Partial Stenosis of Trachea on Antioxidant System in Young Rats

Molochek

Savosko

Utko

et al. 2023

Act. Probl. of the Modern Med.

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Introduction. Recently, there has been a significant rise in the attention of researchers and clinicians towards the issue of complex hypoxic trauma affecting various organs and body systems. This is particularly important when considering the cells that are most vulnerable to oxygen deprivation, including brain tissue, lungs, certain organs of the gastrointestinal tract, systemic immunity. The significance of this problem becomes even more relevant when examining the impact of hypoxia on the cells of sexually immature mammals and humans, as well as exploring potential treatments for acute hypoxic conditions including laryngomalacia and stridor observed in children under the age of one year. Moreover, there are a number of associated complex and unresolved issues in experimental clinical practice. The aim of the study is to investigate changes in the enzyme activity of the pro-oxidant-antioxidant system of the lung tissue cells and the central nervous system (cerebrocortex) during the experimental modelling of respiratory pathology (by ligating the upper trachea of rats), the features of their recovery and the dynamics of this process after the surgical removal of the tracheal ligature. Materials and methods. The studies were performed on 37 sexually immature male Wistar rats, aged 2528 days. The test animals were divided into four groups: the first group served as the control (intact) rats, the second group consisted of rats with experimentally induced tracheal stenosis, which were removed from the experiment in 7 days after the operation, the third group consisted of rats with experimentally induced tracheal stenosis who were removed from the experiment in 21 days after the operation, and the fourth group consisted of rats whose tracheal ligature was removed on the 7th day after the operation and then they were removed from the experiment on the 21st day. The following biochemical parameters were studied: malondialdehyde content, activity of catalase, glutathione peroxidase, glutathione reductase, and superoxide dismutase. Results. The findings obtained demonstrate an increase in malondialdehyde content and antioxidant enzyme activity in the lung and brain tissues of rats on the 7th and 21st days following partial tracheal stenosis. Restoring airway ventilation did not fully normalize these indicators to the control values. In conclusion, the findings indicate that the impaired pro-oxidant-antioxidant balance in lung and central nervous system cells did not completely restore even two weeks after relieving the compressive effect on the trachea and resolving the hypoxic respiratory system disorders partially. This suggests the necessity to continue therapy with pharmacological antioxidant agents following surgical intervention. However, further research is required to explore this aspect of the problem in depth.

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Section: вступunclassified

Impact of Partial Stenosis of Trachea on Antioxidant System in Young Rats

Molochek

Savosko

Utko

et al. 2023

Act. Probl. of the Modern Med.

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“…2 Other acquired causes include neoplasms and trauma involving blunt injury to the neck, clothesline injuries, and suicide attempts by hanging. 3 Autoimmune disorders such as granulomatosis with polyangiitis, systemic lupus erythematosus, sarcoidosis, and IgG4-related diseases have also been shown to cause laryngotracheal stenosis. 4 LTS is considered idiopathic when history reveals no prior airway damage or manipulation and autoimmune workup is negative.…”

Section: Introductionmentioning

confidence: 99%

“…LTS due to iatrogenic causes is frequently a result of intubation, tracheostomy, or tracheal surgeries 2 . Other acquired causes include neoplasms and trauma involving blunt injury to the neck, clothesline injuries, and suicide attempts by hanging 3 . Autoimmune disorders such as granulomatosis with polyangiitis, systemic lupus erythematosus, sarcoidosis, and IgG4‐related diseases have also been shown to cause laryngotracheal stenosis 4 .…”

Section: Introductionmentioning

confidence: 99%

Predictors of Clinical Outcomes in Adult Laryngotracheal Stenosis

et al. 2023

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ObjectivesSequelae of laryngotracheal stenosis (LTS) can be devastating, often necessitating tracheostomy. This study aims to describe the characteristics and outcomes of patients with LTS and identify risk factors for long‐term tracheostomy dependence stratified by etiology.MethodsA retrospective chart review was performed on 215 patients diagnosed with LTS from 09/01/2011 to 12/31/2020. Patients were grouped based on the cause of LTS. Patient factors were compared to evaluate risk factors for long‐term tracheostomy dependence.ResultsOf the 215 patients, 129 (60%) were classified as iatrogenic, 41 (19%) idiopathic, 10 (4.7%) cancer treatment, 18 (8.3%) autoimmune, and 17 (8%) patients unknown. Idiopathic patients were significantly less likely to be tracheostomy‐dependent compared with iatrogenic patients (p < 0.001) and cancer patients (p < 0.05). The mortality rate did not significantly differ among the categories (p = 0.1078). Significant improvement was seen after treatment, as the median percent of stenosis at presentation was 52.5%, and the median percent of stenosis at the most recent visit was 10% (p < 0.001). The autoimmune group received the most steroid injections (mean = 6.56; SD = 11.96). The idiopathic group had the longest surgery‐free interval (mean = 30.8 months; SD = 27.7).ConclusionIatrogenic and cancer patients were more likely to be tracheostomy‐dependent. There was a significant improvement in percent and length of stenosis after treatment, with the idiopathic group having the longest surgery‐free interval. Mortality risk did not differ among the different etiologies of LTS.Level of EvidenceLevel 3 Laryngoscope, 2023

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