Nonoperative Management of Tracheobronchial Injuries in Severely Injured Patients

Kühne, Christian; Kaiser, Gernot M.; Flohé, Sascha; Beiderlinden, Martin; Kuehl, Hilmar; Stavrou, Gregor A.; Waydhas, Christian; Lendemanns, Sven; Paffrath, Thomas; Nast-Kolb, D.

doi:10.1007/s00595-005-3001-z

Cited by 41 publications

(25 citation statements)

References 36 publications

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“…Nonetheless, conservative measures were successfully used in 4 patients with ruptures ranging in length between 1 and 4 centimetres (cases 19, 20, 21 and 23). Such experience, even if limited to four cases, couples with previously reported series in suggesting that the conservative treatment plays a role in traumatic disruptions [20][21][22][23][24][25][26].…”

Section: Discussionsupporting

confidence: 69%

“…Furthermore, Kuhne and Coll. have recently outlined the value of the conservative management in reducing the overall morbidity in patients with multiple injuries [26]. As far as traumatic disruptions are concerned, the conservative treatment is usually reported to play a very minor role, if any.…”

Section: Discussionmentioning

confidence: 99%

“…23 patients were observed overall. with multiple co-morbidities and/or the severely injured [26]. It could then represent a valuable alternative to surgery in selected patients if it turned out effective and free from major complications.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of iatrogenic and traumatic tracheal disruptions

Leoncini¹,

Iurilli²,

Boni³

et al. 2016

Monaldi Arch Chest Dis

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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.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Treatment of iatrogenic and traumatic tracheal disruptions

Leoncini¹,

Iurilli²,

Boni³

et al. 2016

Monaldi Arch Chest Dis

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“…3 Trachea is usually damaged due to one of three mechanisms: high energy trauma to the chest while the glottis is closed, acceleration-or deceleration-type injury or blow against the neck during flexion or hyperextension. 3,4 Minor trauma may also lead to tracheal rupture especially in the membranous part of the trachea, the weakest part of laryngotracheal complex. The rupture may be transverse, longitudinal or complex.…”

Section: Discussionmentioning

confidence: 99%

“…However recently reports on tracheal rupture have increased in number because of improved care of trauma patients. 3 Stable patients with the diagnosis of tracheal rupture might undergo unnecessary surgical treatment, which also increases mortality and morbidity. The objective is to present a six-year old boy with trachea rupture who was managed conservatively with favorable outcome.…”

Section: Introductionmentioning

confidence: 99%

Conservative management of tracheal rupture in a child after blunt trauma

et al. 2016

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Tracheal rupture following blunt trauma is rare but is potentially life threatening. Usually surgical treatment is suggested for tracheal rupture however recently conservative management has also been reported for patients with stable vital signs and stable ventilatory state. The aim of this study is to report a case with tracheal rupture following a blunt trauma to the neck after a bicycle accident that was managed conservatively.

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