Tracheobronchial lacerations after intubation and tracheostomy

Massard, Gilbert; Rouge, Clotilde; Dabbagh, Ahmad; Kessler, Romain; Hents, Jean-Gustave; Roeslin, N; Wihlm, Jean‐Marie; Morand, G

doi:10.1016/0003-4975(96)00083-5

Cited by 169 publications

(167 citation statements)

References 16 publications

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“…(2,3) It is most common in women, in patients with tracheal wall weakness due to inflammatory disease and in patients on corticosteroid therapy, also occurring in patients with congenital tracheal malformations. (3) The major mechanisms of injury are the use of an inappropriate tube size, cuff overinflation and sudden movements in the tube. Direct injury caused by the tube usually occurs after multiple, vigorous attempts at orotracheal intubation in emergency situations.…”

Section: Discussionmentioning

confidence: 99%

“…(7)(8)(9) When surgery is indicated, collar or transverse cervicotomy should be performed, depending on the side of the lesion and at the discretion of the surgeon; in cases of mediastinal tracheal injury, right thoracotomy should be performed in the fourth intercostal space. (3,8) Subsequently, the tracheal laceration is treated by primary closure using a single layer of absorbable suture. (3,8) All of the case series of post-intubation tracheal injury have involved small numbers of patients, of varying ages, and there has been a predominance of females.…”

Section: Casementioning

confidence: 99%

“…(3,8) Subsequently, the tracheal laceration is treated by primary closure using a single layer of absorbable suture. (3,8) All of the case series of post-intubation tracheal injury have involved small numbers of patients, of varying ages, and there has been a predominance of females. In such studies, the time elapsed between the occurrence of the injury and the diagnosis has ranged from 0 to 124 h. The reported mortality is low, being slightly higher in patients submitted to surgical treatment.…”

Section: Casementioning

confidence: 99%

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Laceração traqueal pós-intubação: análise de três casos e revisão de literatura

et al. 2009

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A 78-year-old female patient, without comorbidities, presented with syncope, a drop in the level of consciousness and respiratory dysfunction. The clinical hypothesis was cerebrovascular accident. The patient underwent emergency orotracheal intubation at home and was taken IntroductionTracheal injury due to orotracheal intubation is a rare and potentially fatal complication. It can be caused by a single-lumen or a double-lumen tube, typically in emergency orotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and it is more prevalent in women.(1) Diagnosis is confirmed by fiberoptic bronchoscopy, and the treatment can be either conservative or surgical. Post-intubation tracheal injury AbstractPost-intubation tracheal injury is a rare and potentially fatal complication. Among the most common causes, cuff overinflation and repetitive attempts of orotracheal intubation in emergency situations are paramount. Diagnosis is based on clinical and radiological suspicion, confirmed by fiberoptic bronchoscopy. Both conservative and surgical management apply, and the decision-making process depends on the patient profile (comorbidities, respiratory stability), characteristics of the lesion (size and location) and the time elapsed between the occurrence of the injury and the diagnosis. We report the cases of three patients presenting tracheal laceration due to traumatic orotracheal intubation, two submitted to surgical treatment and one submitted to conservative treatment.Keywords: Tracheal diseases; Rupture; Intubation. ResumoA laceração traqueal pós-intubação é uma complicação rara e potencialmente fatal. Entre as principais causas, se destacam a hiperinsuflação do balonete e tentativas repetidas de intubação em situações de emergência. O diagnóstico depende da suspeita clínico-radiológica e da confirmação por fibrobroncoscopia. O manejo pode ser conservador ou cirúrgico, e essa opção depende de fatores do paciente (comorbidades, estabilidade ventilatória), das características da lesão (tamanho e topografia) e do tempo decorrido até o diagnóstico. O presente estudo relata três casos de laceração traqueal decorrente de trauma de intubação com dois pacientes submetidos a tratamento operatório e um deles ao tratamento conservador.Descritores: Doenças da traqueia; Ruptura; Intubação.

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Section: Discussionmentioning

confidence: 99%

Section: Casementioning

confidence: 99%

Section: Casementioning

confidence: 99%

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Laceração traqueal pós-intubação: análise de três casos e revisão de literatura

et al. 2009

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“…В настоящее время основной причиной рубцо-вого стеноза трахеи является повреждение трахеаль-ной стенки при искусственной вентиляции легких через интубационную или трахеостомическую труб-ку [7,8,[15][16][17][18]. Через входные ворота в слизистой оболочке, образовавшиеся в результате травмы, в стенку трахеи проникает патогенная флора и возни-кает интрамуральное воспаление, которое может быть гнойно-некротическим с последующим заме-щением трахеальных структур рубцовой тканью, су-живающей просвет дыхательного пути.…”

Section: результаты и обсуждениеunclassified

Simultaneous resection of the two tracheal fragments for cicatrical stenosis

Vd¹,

Ma²,

Va³

et al. 2015

Khir. Z. im. N.I. Pirogova

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“…Tracheal and tracheobronchial injuries are rare, but serious consequences of blunt trauma, penetrating wounds and iatrogenic injuries associated with endotracheal intubation and mechanical ventilatory support and with endobronchial intervention including airway dilatation (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Evolutional trends in the management of tracheal and bronchial injuries

Madden

2017

J. Thorac. Dis.

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Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak. There may be other additional injuries to consider in trauma patients with large airway injury. Familiarity with the diagnosis and management of large airway injuries is important for medical teams engaged in emergency medicine, thoracic surgery and medicine, anaesthesia and intensive care. Although early surgical intervention is the mainstay of treatment, endobronchial manoeuvres to seal defects are receiving increasing attention particularly for patients with medical co-morbidities which may contraindicate formal surgery or transfer or where local surgical expertise is not available.

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Tracheobronchial lacerations after intubation and tracheostomy

Cited by 169 publications

References 16 publications

Laceração traqueal pós-intubação: análise de três casos e revisão de literatura

Laceração traqueal pós-intubação: análise de três casos e revisão de literatura

Simultaneous resection of the two tracheal fragments for cicatrical stenosis

Evolutional trends in the management of tracheal and bronchial injuries

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