Management of postintubation membranous tracheal rupture

Carbognani, Paolo; Bobbio, Antonio; Cattelani, L; Internullo, Eveline; Caporale, Domenico; Rusca, Michele

doi:10.1016/s0003-4975(03)01344-4

Cited by 124 publications

(100 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nonsurgical treatment is advisable in small (<2 cm) and uncomplicated cases. 5 With this case report, we intend to refer paratracheal cysts as a possible cause for tracheal rupture, infrequently described in literature but not so uncommon in population.…”

Section: Discussionmentioning

confidence: 95%

Paratracheal cyst rupture: a differential diagnosis for tracheal rupture

Marques¹,

Henriques²,

Azevedo³

et al. 2012

European Journal of Anaesthesiology

View full text Add to dashboard Cite

Tracheobronchial rupture is a rare but potentially life-threatening complication commonly caused by neck and chest trauma. Iatrogenic tracheobronchial rupture can be caused by intubation, tracheostomy, bronchoscopy but also linked to pre-existing primary diseases. Paratracheal air cysts, infrequently described in literature, seem to be associated with obstructive lung disease and weaknesses in right posterior lateral wall of the trachea. We report a case of a paratracheal air cyst rupture in a previous healthy patient. PALAVRAS-CHAVE Ruptura traqueal; Cisto paratraqueal; Complicações anestésicas Ruptura de cisto paratraqueal: um diagnóstico diferencial para ruptura traquealResumo A ruptura traqueobrônquica (RTB) é uma complicação rara, mas potencialmente fatal comumente causada por trauma de pescoço e tórax. A RTB iatrogênica pode ser causada por intubação, traqueostomia, broncoscopia, mas também pode estar relacionada a doenças primárias pré-existentes. Os cistos aéreos paratraqueais, raramente descritos na literatura, parecem estar associados à doença pulmonar obstrutiva e fraqueza da parede posterolateral direita da traqueia. Relatamos o caso de uma ruptura de cisto aéreo paratraqueal em paciente previamente saudável.

show abstract

Section: Discussionmentioning

confidence: 95%

Paratracheal cyst rupture: a differential diagnosis for tracheal rupture

Marques¹,

Henriques²,

Azevedo³

et al. 2012

European Journal of Anaesthesiology

View full text Add to dashboard Cite

show abstract

“…Both standard and fascinating innovative surgical procedures have been largely proposed as the gold standard of therapy for wide and/or full thickness tracheal disruptions [1-9, 27, 28], in order to prevent severe acute or late complications such as respiratory failure, purulent mediastinitis and ventilation disorders [3,4,6,7,18,29]. Such a statement is not supported by any proven evidence and should, in our opinion, be reconsidered.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheal disruptions are usually considered as life threatening conditions, responsible for potentially fatal, acute or late complications if not approached early by surgery [1][2][3][4][5][6][7][8]. Nonetheless, the optimal management of such injuries is still controversial [9].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, only small, non full-thickness iatrogenic injuries are usually deemed suitable for conservative management [1][2][3][4][5][6][7][8][9]. Nonetheless, a few cases and a few recent series have been reported with even wide full-thickness iatrogenic tracheal lacerations successfully managed by means of conservative treatment [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of iatrogenic and traumatic tracheal disruptions

Leoncini¹,

Iurilli²,

Boni³

et al. 2016

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Background and aim. The optimal management of tracheal disruptions is still controversial. It is usually postulated that lesions wider than 1 or 2 centimetres and/or lesions of full-thickness should be treated by surgery at an early stage. Such a statement is not supported by any proven evidence. On the contrary, the conservative management of such injuries has also produced very good results according to recent reports. The aim of this study is to investigate whether conservative treatment can be safely used for wide tracheal lacerations and to assess any possible association between clinical features and modality of treatment. Methods. Records of all patients with iatrogenic and traumatic tracheal disruptions observed between January 1992 and December 2006 were collected and retrospectively reviewed. Data regarding mechanism of injury, clinical and morphological features and modalities of treatment were registered. All possible associations between clinical features and modalities of treatment were investigated. Results. 23 patients were observed overall. There were 6 males and 17 females with a median age of 58 years (range 20-84 yrs). 15 patients had undergone single tube intubation. One patient had his trachea injured during an esophagectomy. Ruptures were secondary to blunt (n=5) and open (n=2) trauma in 7 patients. Lesions varied in length between 1 and 7 centimetres (median length 3 centimetres) and all were full-thickness. The time interval until diagnosis varied between 0 and 72 hours (median 6 hours). Respiratory failure was evident in 7 patients. 16 patients (69.5%) with lacerations ranging in length between 1 and 5.5 centimetres (median length 2.75 cm) underwent conservative treatment. Seven patients (30.5%) underwent surgery. The follow up was completed for 16 patients and varied between 15 and 105 months (median 22.5). One patient died after surgical treatment. No mortality or late major sequelae were registered after conservative treatment. Female sex, absence of respiratory failure and delayed diagnosis was associated with the conservative treatment. Conclusions. Conservative treatment can play a major role even in cases of wide tracheal lacerations. Clinical rather than morphological features should be regarded as main criteria for treatment. The conservative treatment is particularly indicated in the case of stable respiratory parameters independent of the size and the depth of the lesion.

show abstract

“…The overall incidence is 1/20.000 following elective endotracheal intubation but it increases three-fold in case of emergency endotracheal intubation (1). There are several risk factors for PITL due to (I) the patient's condition: anatomical tracheal abnormalities, weakness of pars membranosa, underlying lung disease, advanced age, female; (II) operator's experience: multiple forced intubations, incorrect position of the endotracheal tube, reposition of endotracheal tube with inflated cuff; (III) type of endotracheal tube: inappropriate size, doublelumen tube; and (IV) technique of intubation: using stylet, cuff over-inflation (1,2). In the most of cases, the PITS is caused by the tip of the endotracheal tube that tears the pars membranosa while advancing into the trachea.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic treatment with fibrin glue of post-intubation tracheal laceration

et al. 2017

View full text Add to dashboard Cite

Post-intubation tracheal laceration (PITL) is a rare and potential life-threatening condition requiring prompt diagnosis and treatment. A conservative treatment is indicated in patients with laceration <2 cm in length while surgery is the treatment of choice for laceration >4 cm. For laceration between 2-4 cm, the best treatment is debate; some authors recommend surgery while others do not definitely exclude endoscopic treatment. Herein, we reported the endoscopic treatment with fibrin glue of PITL.The procedure is performed using a standard video-bronchoscopy in operating room; the patient is in spontaneous breathing and deep sedation. After identification of tracheal laceration, the fibrin glue is injected through a dedicated double lumen catheter into the lesion. After mixing both components of fibrin glue,

show abstract

Management of postintubation membranous tracheal rupture

Cited by 124 publications

References 8 publications

Paratracheal cyst rupture: a differential diagnosis for tracheal rupture

Paratracheal cyst rupture: a differential diagnosis for tracheal rupture

Treatment of iatrogenic and traumatic tracheal disruptions

Endoscopic treatment with fibrin glue of post-intubation tracheal laceration

Contact Info

Product

Resources

About