Airway injury from the presence of endotracheal tubes and the association with subglottic secretion drainage: a prospective observational study
Stephanie SibleyIan BallChristine L. D’ArsignyJohn DroverJason W. ErbI. GalvinDaniel HowesRoy IlanDavid MessengerSusan L. MoffattChristopher M. ParkerStacy RidiJohn Muscedere
3
Citation
26
Reference
10
Related Paper
Citation Trend
Keywords:
Tracheotomy
Cuff
Subglottic stenosis
Tracheal tube
Tracheotomy
Laryngotracheal Stenosis
Cite
Citations (3)
Tracheotomy
Cite
Citations (0)
Tracheal stenosis caused by tracheotomy and intubation is considered intractable. Although the segmental tracheal resection and endoscopic intervention are available, they usually result in great operation injury or are difficult to perform. A patient with acquired tracheal stenosis was treated with tracheotomy-coblation. The patient was followed up by bronchoscopy every 2 months. After 6-month follow-up, the symptoms of dyspnea and hoarseness disappeared and no tracheal stenosis was observed. The present technique, tracheotomy-coblation, is advantageous with less injury and easy to perform.
Tracheotomy
Cardiothoracic surgery
Subglottic stenosis
Cite
Citations (3)
We randomly allocated 60 patients with normal airways into three groups to compare the ease of fibrescope‐aided tracheal intubation using 8.0‐mm internal diameter (group F 8 ) and 6.0‐mm (group F 6 ) reinforced tracheal tubes and to evaluate the efficacy of the laryngeal mask as an aid for fibreoptic tracheal intubation (group L). In group F 8 tracheal intubation was optimal in 2 of 20 patients and in two patients in whom intubation over the fibrescope was difficult the attempts resulted in inadvertent oesophageal intubation. In group F 6 intubation was always successful and significantly easier than in group F 8 (p < 0.005; 95% confidence interval for the difference in the proportion of the optimal intubation grade: 20–70%). In group L tracheal intubation was optimal in 18 of 20 patients and easier than in group F 6 (p = 0.014; 95% confidence interval for difference: 10–60%). In both groups F 6 and L tracheal intubation was completed within less than about 1 min. We conclude that conventional fibrescope‐aided tracheal intubation with a 6.0‐mm tracheal tube is easier than with an 8.0‐mm tube and that the laryngeal mask facilitates fibrescope‐aided tracheal intubation.
Tracheal tube
Mascara
Cite
Citations (74)
Tracheotomy
Cite
Citations (1)
Of 158 cases of subglottic stenosis 115 were congenital and 43 acquired. Current follow-up has been obtained in 146 (92%) which constitutes the determinate group. Although stridor was the most common presenting symptom of the congenital group, 34% presented with recurrent or prolonged episodes of croup. Tracheotomy was required in 47 of the 107 determinate cases (44%). Further management of the congenital cases was based on the experience that children outgrow this disorder; periodic dilatation may augment the natural process. Of those infants and children tracheotomized, all but five have been decannulated, and there was one death — a mortality rate of 2.1%. Acquired subglottic stenosis proved to be a more difficult management problem. Tracheotomy was necessary in 38 of the 39 determinate cases (97%). Repeated active dilatations for prolonged periods were usually required as well as endoscopic removal of granulation tissue. Of those infants and children tracheotomized, all but eight have been decannulated. There were nine deaths; five were due to unrelated underlying disease; four were attributable to complications of long-term tracheostomy. Thus, in the entire series, 85 infants and children required tracheotomy and five deaths may be attributable to long-term tracheostomy complications — a mortality rate of 5.9%.
Tracheotomy
Subglottic stenosis
Croup
Subglottis
Cite
Citations (32)
Tracheotomy
Cite
Citations (1)
Tracheotomy
Cite
Citations (0)
Tracheotomy
Cite
Citations (94)