Management of postintubation tracheal stenosis with bronchoscope methods-An experience from two centers.

IF 0.8 Q4 RESPIRATORY SYSTEM Respirology Case Reports Pub Date : 2024-09-08 eCollection Date: 2024-09-01 DOI:10.1002/rcr2.70014
Arvindran Alaga, Vineet Simhan, Srivatsa Lokeshwaran, Sunil Kumar K, Sanjana Chetana Shanmukhappa
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Abstract

Tracheal stenosis is a common complication of endotracheal intubation or tracheostomy, resulting in significant morbidity and mortality. Bronchoscope interventions have been proposed as a safe alternative for the management of post-intubation post-intubation tracheal stenosis (PITS). Data for patients diagnosed with PITS across two hospitals, between 2021 and 2022, encompassing demographic, clinical, and procedural details were gathered from electronic medical records, and analysed. Primary outcomes centred on assessing the incidence and severity of PITS through bronchoscope examination and radiological imaging, and the efficacy of bronchoscope interventions, including stenting and the application of mitomycin C. Twelve patients were managed for PITS. Majority of patients were females (9/12) with mean age of 46.41 years. Presenting signs and symptoms were dyspnea, rhonchi and failed extubation, the mean duration of intubation/ tracheostomy is 16.41 days (range: 3-40 days). Most common comorbidity was type 2 diabetes, (5 patients, 41.6%). The lesions mean length was 3.09 cm and Cotton-Meyer Grade II and III. Prompt evaluation is crucial, in these patients. The Cotton-Meyer grade is pivotal in treatment decisions, with intubating times correlating with the severity of stenotic disease. Our case series demonstrates the increasing utility of bronchoscopy in managing these cases.

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用支气管镜方法处理插管后气管狭窄--来自两个中心的经验。
气管狭窄是气管插管或气管切开术的常见并发症,会导致严重的发病率和死亡率。有人提出,支气管镜干预是治疗气管插管后气管狭窄(PITS)的一种安全替代方法。我们从电子病历中收集并分析了 2021 年至 2022 年期间两家医院诊断为 PITS 患者的数据,包括人口统计学、临床和手术细节。主要结果集中在通过支气管镜检查和放射成像评估PITS的发生率和严重程度,以及支气管镜干预措施的疗效,包括支架植入和丝裂霉素C的应用。大多数患者为女性(9/12),平均年龄为 46.41 岁。出现的体征和症状为呼吸困难、啰音和拔管失败,平均插管/气管切开时间为 16.41 天(范围:3-40 天)。最常见的合并症是 2 型糖尿病(5 名患者,占 41.6%)。病变平均长度为 3.09 厘米,Cotton-Meyer 分级为 II 级和 III 级。对这些患者进行及时评估至关重要。Cotton-Meyer 分级对治疗决策至关重要,插管时间与狭窄疾病的严重程度相关。我们的系列病例表明,支气管镜在治疗这类病例中的作用越来越大。
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来源期刊
Respirology Case Reports
Respirology Case Reports RESPIRATORY SYSTEM-
CiteScore
1.40
自引率
0.00%
发文量
178
审稿时长
8 weeks
期刊介绍: Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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