Rigid bronchoscopic dilatation of postintubation tracheal stenosis

Following cardiac arrest a 41-year-old patient was resuscitated for 40 min and required mechanical ventilation for 27.5 h. Acute shortness of breath and inspiratory stridor developed 7 days after successful extubation. Bronchoscopy revealed a subtotal tracheal stenosis caused by extensive fibrinous membranes. Local ischaemia caused by cuff pressure seems to be a likely explanation with an additional component of general hypoperfusion and haemodynamic instability which led to gastric bleeding (classification according to Forrest IIc) from ischaemic ulcers.

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“…Als ursächlich werden eine lokale Ischämie durch den Tubuscuff und dadurch bedingt Durchblutungsstörungen der Trachea vermutet [8].…”

Section: Diskussionunclassified

“…Bei einer Größe von 181 cm und einem Gewicht von 90 kg wird er in der Notfallsituation mit einem Tubus von 8,5 mm ID intubiert (der bei 23 cm ab Zahnreihe fixiert wird) und maschinell mit 100%igem Sauerstoff beatmet [Atemminutenvolumen (AMV) 8 …”

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Akute subglottische Trachealstenose nach Reanimation

et al. 2007

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“…4,5 Although rigid bronchoscopy is efficacious and reliable in determining the intensity of stenosis, it is an invasive tool. 6 Stricture has been reported in 10%-22% of cases after Asian Cardiovascular & Thoracic Annals 21 (2) 181-186 ß The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492312454537 aan.sagepub.com tracheotomy or tracheal intubation, but only 1%-2% of patients display symptoms. 7 In more than 50% of patients with stricture, lumen diameter is not noted and there are no apparent symptoms.…”

Section: Introductionmentioning

confidence: 98%

Evaluation of plethysmography for diagnosis of postintubation tracheal stenosis

Jamaati

Shadmehr

Aloosh

et al. 2013

Asian Cardiovasc Thorac Ann

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“…Günümüzde, endotrakeal tüp ya da trakeostomi kanül kaflarının uyguladığı basıncın hava yolunda iskemik nekroza yol aç-tığı ve ardından oluşan granülasyon dokusunun aşırı büyüyerek trakeal stenoza neden olduğu anlaşılmış, bu kafların kullanım ve tasarımları modifiye edilmiş-tir. Bunun sonucunda iatrojenik trakeal stenoz oranı azalsa da hâlen trakeal rezeksiyon ve rekonstrüksiyo-nun en sık endikasyonu endotrakeal entübasyon ve trakeostomidir (3,4) . Laringotrakeal stenozların tanı-sı, anamnez, fizik muayene, radyolojik görüntüleme yöntemleri ve bronkoskopi ile konur (5) .…”

Section: Introductionunclassified