Tracheal stenosis due to endotracheal tube cuff hyperinflation: a preventable complication

Abstract

Endotracheal intubation injuries are rare, but may be devastating—mostly among the pediatric patients or when these occur in the distal trachea. Such complications typify a therapeutic challenge, which, besides requiring intellectual and technical resources, takes a long time to reach a resolution. The authors present the case of a 15-year-old girl admitted with an abnormal state of consciousness due to diabetic ketoacidosis. She was submitted to endotracheal intubation with hyperinflation of the tube cuff, which rendered tracheal necrosis and detachment of the tracheal mucosa, and consequent obstruction. Later, she developed scarring retraction and stenosis. The patient was successfully treated with an endotracheal prosthesis insertion. The aim of this report is to illustrate a preventable complication.

Survey of current trends in the management of traumatic subcutaneous emphysema in dogs

“…Tracheoscopy or esophagoscopy can provide information on the location and severity of damage to the respiratory or digestive tracts to guide treatment 6 . Recommendations regarding endoscopic examination in cases of suspected tracheal or esophageal injuries vary within the human literature, with some sources maintaining that endoscopic examination of the trachea/bronchi is obligatory and others suggesting the increased pressure with insufflation may worsen the original injury and SCE 3,9 . The expense and added morbidity associated with surgical exploration may be avoided with thorough noninvasive diagnostics.…”

“…6 Recommendations regarding endoscopic examination in cases of suspected tracheal or esophageal injuries vary within the human literature, with some sources maintaining that endoscopic examination of the trachea/bronchi is obligatory and others suggesting the increased pressure with insufflation may worsen the original injury and SCE. 3,9 The expense and added morbidity associated with surgical exploration may be avoided with thorough noninvasive diagnostics. The questionnaire was constructed to determine if a difference existed between groups, but it did not attempt to determine why respondents chose specific diagnostics.…”

A influência do tratamento cirúrgico do refluxo gastroesofágico em pacientes com estenose de traqueia

“…A traqueia é um importante órgão que provê a insuflação e desinsuflação das vias aéreas por meio de seu lúmen. As doenças traqueais são de difícil tratamento, podendo se transformar em verdadeiros desafios e, geralmente, acabam levando à obstrução e insuficiência respiratória como na estenose traqueal e traqueomalácia (1)(2)(3)(4) .…”

“…Usualmente a estenose traqueal ocorre em razão da a intubação prolongada ou lesão traqueal externa, como no trauma (2) . O aumento progressivo de pacientes submetidos a tratamento ventilatório prolongado por meio de intubação orotraqueal, nasotraqueal ou tubos de traqueostomia tem levado a lesões iatrogênicas da laringe e traqueia, em graus variáveis e, muitas vezes, de difícil solução.…”