Conservative treatment of tracheal injuries

Steindor, Mathis; Schuster, Antje; Hoehn, Thomas; Mayatepek, Ertan; Santos, Mariana Avelino dos; Angenendt, Steffen; Klee, Dirk; Schramm, Dirk

doi:10.1016/j.epsc.2014.05.011

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…Even in the absence of esophageal involvement, distal tracheal injuries also present a unique challenge; when injuries approximate the carina, bypassing the level of injury can be difficult. As a result, many patients with distal injuries undergo surgical repair, although conservative management with extra corporeal membrane oxygenation has also been reported . In the patient described here, bypassing the tracheal injury required that the endotracheal tube be positioned in either the right or left main bronchus.…”

Section: Discussionmentioning

confidence: 96%

“…In the patient described herein, the initial effects of ventilation were monitored by end‐tidal devices in the trauma suite prior to obtaining an arterial blood gas. However, despite an acceptable end‐tidal CO 2 on capnometry, underestimations of PaCO 2 may occur following trauma . Hyperventilation was performed to reduce to reduce end‐tidal CO 2 to a goal of 35–40 mm Hg, while balancing reductions in PaCO 2 with the potential reductions in cerebral blood flow (CBF).…”

Section: Discussionmentioning

confidence: 99%

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Conservative management of pediatric tracheal rupture

2016

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Traumatic injuries to the pediatric trachea are uncommon events that require prompt diagnosis and management. When they do occur, tracheal injuries often arise in the setting of high impact trauma and are accompanied by major injuries to other organ systems. In this report, we present the diagnosis and conservative management of tracheal rupture at the carina in an 11-year-old female with severe intracranial injuries. Pediatr Pulmonol. 2017;52:E1-E3. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Conservative management of pediatric tracheal rupture

2016

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“…1 Documented pediatric cases of these airway injuries are few. Contributing factors to the low incidence of pediatric tracheal injury are twofold-(1) the consideration that a child's anatomy provides additional protection to the trachea because of their large mandibles and short necks reducing the risk for injury, and (2) the acknowledgment that many children with tracheal injuries likely die before reaching the hospital.…”

Section: Discussionmentioning

confidence: 97%

Complete Tracheal Transection Following Blunt Trauma in a Pediatric Patient

Holmes

Hanson²

2015

Journal of Trauma Nursing

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Tracheal injury from blunt trauma is a rare, life-threatening condition in pediatric patients. Rapid assessment and identification of the severity of the injury will increase the likelihood of survival. Subcutaneous emphysema, pneumomediastinum, and persistent pneumothoraces after chest tube placement should be considered in the index of suspicion for tracheal injury. Treatment for a complete tracheal transection includes rapid airway securement via endotracheal tube or tracheostomy and careful surgical repair in the operating room in conjunction with bronchoscopy.

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“…A more conservative method in small superficial lesions is to isolate such injury, through an endotracheal tube with the cuff distal to the lesion which needs a very close and permanent monitoring of cuff pressure so to avoid mucosal damage due to the presence of the tube itself [23]. However, the important point is which patients will benefit with an aggressive treatment and which will do with more conservative measures…”

Section: Casementioning

confidence: 99%

Use of Platelet Rich Plasma (PRP) in the Treatment of Acute Post Intubation Tracheal Rupture: Report of Two Cases

S¹,

Z²,

S³

et al. 2015

IJCM

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The use of PRP involves a complex network of molecular events which accelerate tissue regeneration due to its richness in growth factors plus a variety of biologic mediators. Several communications tell us about its usefulness on the dental implantology field, plastic surgery, orthopedics and peripheral nerve regeneration after trauma. We have presented our successful experience of its use in pneumology when treating severe hemoptysis, respiratory fistulae, spontaneous pneumothorax and one tracheal rupture. In this article we present two cases of post intubation tracheal rupture successfully treated with the local instillation of PRP on one of them and with the injection of PRP along the lips of the tracheal wound on the other. Tracheal rupture is a rare but life threatening complication of emergency intubation requiring an effective response in order to avoid the risk of patient death due to secondary mediastinitis and sepsis. Up to now there is no general consensus in the treatment of this condition and alternatives in use are not universally accepted. The use of local autologous PRP in our experience has demonstrated a favorable performance in such cases, turning it in a highly promising tool for the treatment of conditions such as this, in which a rapidly effective and minimally invasive handling is required.

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Conservative treatment of tracheal injuries

Cited by 7 publications

References 11 publications

Conservative management of pediatric tracheal rupture

Conservative management of pediatric tracheal rupture

Complete Tracheal Transection Following Blunt Trauma in a Pediatric Patient

Use of Platelet Rich Plasma (PRP) in the Treatment of Acute Post Intubation Tracheal Rupture: Report of Two Cases

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