Lower airway injuries and anaesthesia

Devitt, J. Hugh; Boulanger, Bernard R.

doi:10.1007/bf03011256

Cited by 50 publications

(21 citation statements)

References 41 publications

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“…Such injuries may also present in a subtle way. The most common presentations are dyspnea and subcutaneous emphysema [13, 14]. Other symptoms may include hoarseness, signs of external trauma, stridor, pneumothorax, pneumomediastinum or pneumopericardium, oxygen desaturation, cyanosis, and hemoptysis [15].…”

Section: Discussionmentioning

confidence: 99%

Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

Sehgal

Chance

Steliga

2014

Case Reports in Anesthesiology

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Tracheobronchial injuries are rare but life threatening sequel of blunt chest trauma. Due to the difficult nature of these injuries and the demanding attributes of the involved surgery, the anesthesiologist faces tough challenges while securing the airway, controlling oxygenation, undertaking one-lung ventilation, maintaining anesthesia during tracheal reconstruction, and gaining adequate postoperative pain control. Amongst the few techniques that can be used with tracheobronchial injuries, cross field ventilation is a remotely described and rarely used technique, especially in injuries around the carina. We effectively applied cross field ventilation in both our cases and the outcome was excellent.

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Section: Discussionmentioning

confidence: 99%

Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

Sehgal

Chance

Steliga

2014

Case Reports in Anesthesiology

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“…In patients with communication between the airway rent and the pleural space, most of the delivered breath may be vented into the pleural space[6] leading to a tension pneumothorax. We preferred IPPV with low tidal volume and high respiratory rate as rigid bronchoscopy was done before the repair and bucking or movement during bronchoscopy could augment airway injury.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Recommended methods of OLV in children are balloon-tipped bronchial blockers, Univent tubes, double lumen tubes (DLT), and single lumen endotracheal tube. [11] A DLT cannot be used in a small child.…”

Section: Discussionmentioning

confidence: 99%

Foreign body removal with repair of iatrogenic tracheo-bronchial tear repair: An anesthetic challenge

Lahori

Simick

et al. 2011

J Anaesthesiol Clin Pharmacol

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Foreign body aspiration into the airway is common in the pediatric age group and its anesthetic management is a challenge. Iatrogenic tracheo-bronchial injury further worsens the situation. Flexible pediatric fiberscope is the gold standard for securing the airway in cases of airway injury. We present a case of a 7-year-old girl who presented to the hospital with signs and symptoms of foreign body aspiration and suspected tracheo-bronchial tree injury. The impacted foreign body was removed by rigid bronchoscopy and the presence of a tracheo-bronchial tear was confirmed. To repair the airway tear, thoracotomy was planned necessitating one lung ventilation. A pediatric flexible fiberscope was not available, so left endobronchial intubation for one lung ventilation was done with the help of an airway exchange catheter using a rigid bronchoscope as a conduit. Subsequent intra-operative and post-operative period were uneventful.

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“…Blind endotracheal intubation with the tube’s cuff inflated proximally to the injury and positive pressure ventilation may increase the air leak and lead to severe respiratory insufficiency and pending respiratory arrest [42]. Rapid bronchoscopic evaluation of the airway should be undertaken and once the site of the injury has been identified single lung ventilation should begin; the tube can be guided into the uninjured bronchus in case of a bronchial rupture, or we may use a double lumen tube to intubate the patient [3].…”

Section: Reviewmentioning

confidence: 99%

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment

Prokakis

Koletsis

Dedeilias

et al. 2014

J Cardiothorac Surg

135

150

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Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury. Bronchoscopy and chest computed tomography with MPR and 3D reconstruction of the airway represent the procedures of choice for the definitive diagnosis. Endotracheal intubation under bronchoscopic guidance is the key point to gain airway control and appropriate ventilation. Primary repair with direct suture or resection and an end to end anastomosis is the treatment of choice for patients suffering from tracheobronchial injuries (TBI). The surgical approach to the injured airway depends on its location. Selected patients, mainly with iatrogenic injuries, can be treated conservatively as long as the injury is small (<2 cm), a secure and patent airway and adequate ventilation are achieved, and there are no signs of sepsis. Patients with delayed presentation airway injuries should be referred for surgical treatment. Intraoperative evaluation of the viability of the lung parenchyma beyond the site of stenosis/obstruction is mandatory to avoid unnecessary lung resection.

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Lower airway injuries and anaesthesia

Cited by 50 publications

References 41 publications

Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

Foreign body removal with repair of iatrogenic tracheo-bronchial tear repair: An anesthetic challenge

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment

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