Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

Ahn, Hye‐Jin; Cho, Jeong Su; Kim, Yeong‐Dae; Hoseok, I

doi:10.5761/atcs.oa.13-00335

Cited by 24 publications

(20 citation statements)

References 11 publications

(17 reference statements)

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“…Two studies have shown that most patients with PITS experienced up to five days of intubation (11, 12). However, for a patient with dyspnea and a history of tracheal intubation for more than 24 hours, tracheal stenosis should be considered as the first differential diagnosis (8, 13, 14).…”

Section: Introductionmentioning

confidence: 99%

Incidence Rate of Post-Intubation Tracheal Stenosis in Patients Admitted to Five Intensive Care Units in Iran

Farzanegan¹,

Farzanegan²,

Zangi³

et al. 2016

Iran Red Crescent Med J

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BackgroundTracheal stenosis is one of the worst complications associated with endotracheal intubation and it is the most common reason for reconstructive airway surgeries. Due to various local risk factors, the incidence rate of tracheal stenosis may vary in different countries. In order to estimate the incidence rate of post-intubation tracheal stenosis (PITS) in patients admitted to an intensive care unit (ICU), a follow-up study was planned. As there was no similar methodological model in the literature, a feasibility step was also designed to examine the whole project and to enhance the follow-up rate.ObjectivesTo estimate the PITS incidence rate in patients admitted to ICUs, as well as to evaluate the feasibility of the study.MethodsThis prospective cohort study was conducted in five hospitals in two provinces (Tehran and Arak) of Iran from November 2011 to March 2013. All patients admitted to ICUs who underwent more than 24 hours of endotracheal intubation were included. Upon their discharge from the ICUs, the patients received oral and written educational materials intended to ensure a more successful follow-up. The patients were asked to come back for follow-up three months after their extubation, or sooner in case of any symptoms developing. Those with dyspnea or stridor underwent a bronchoscopy. The asymptomatic patients were given a spirometry and then they underwent a bronchoscopy if the flow-volume loop suggested airway stenosis.ResultsSome seventy-three patients (70% men) were included in the study. Multiple trauma secondary to motor vehicle accidents (52%) was the most common cause of intubation. Follow-ups were completed in only 14 (19.2%, CI = 0.109 - 0.300) patients. One patient (7%, CI = 0.007 - 0.288) developed symptomatic tracheal stenosis that was confirmed by bronchoscopy. The barriers to a successful follow-up were assessed on three levels: ineffective oral education upon discharge, improper usage of educational materials, and difficulties to attending follow-up visits. There were also some important obstacles in terms of human, time, material, and cost resources, as well as data management.ConclusionsTo enhance the follow-up rate, three strategies were proposed: patient-focused strategies such as emphasizing patient education upon discharge and providing rewards; structural-focused strategies such as scheduling home visits and uploading questionnaires onto the research center’s website; and provider-focused strategies such as selecting coordinators with good communication skills. All necessary resources should also be re-arranged for a multicenter national study.

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Section: Introductionmentioning

confidence: 99%

Incidence Rate of Post-Intubation Tracheal Stenosis in Patients Admitted to Five Intensive Care Units in Iran

Farzanegan¹,

Farzanegan²,

Zangi³

et al. 2016

Iran Red Crescent Med J

View full text Add to dashboard Cite

show abstract

“…Options for front of neck access, including awake cricothyrotomy or tracheotomy, were limited because of cricoid involvement and previous surgery. Implementation of venovenous extracorporeal membrane oxygenation can be potentially helpful in these circumstances and facilitate establishment of a safe distal airway,13 but was deemed unnecessary in this case.…”

Section: Discussionmentioning

confidence: 98%

Airway Management via Laryngeal Mask in Laryngotracheal Resection

Zardo

Kreft

Hachenberg

2015

THORAC CARDIOV SURG Reports

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We present a case of impassable subglottic stenosis scheduled for tracheal resection and reconstruction managed by establishing a supraglottic airway. Despite careful preoperative evaluation, the stenosis was localized higher than anticipated, rendering conventional intubation impossible. Laryngeal mask bridging to cross-field ventilation was feasible and jet ventilation and cardiopulmonary bypass were available as emergency strategies. Surgery and emergence went uneventful. Perioperative considerations are discussed in this report.

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“…[7,8] However, recently, reports showed that its incidence decreased to 6% due to improvement of mechanical ventilation equipments. [9] Nevertheless, despite all technological developments in intensive care units, tracheal stenosis related to mechanical ventilation is still on the agenda of thoracic surgeons.…”

Section: Discussionmentioning

confidence: 99%

Does duration of mechanical ventilation affect the resection length in benign tracheal stenosis?

Altuntas¹

2016

Turk Gogus Kalp Dama

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Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

Cited by 24 publications

References 11 publications

Incidence Rate of Post-Intubation Tracheal Stenosis in Patients Admitted to Five Intensive Care Units in Iran

Incidence Rate of Post-Intubation Tracheal Stenosis in Patients Admitted to Five Intensive Care Units in Iran

Airway Management via Laryngeal Mask in Laryngotracheal Resection

Does duration of mechanical ventilation affect the resection length in benign tracheal stenosis?

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