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

      case-report

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          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.

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          Subglottic stenosis.

          Michael Rutter, Niall D Jefferson, Aliza P Cohen (2016)
          Subglottic stenosis (SGS) is a congenital or acquired condition characterized by a narrowing of the upper airway extending from just below the vocal folds to the lower border of the cricoid cartilage. With the introduction of prolonged intubation in neonates (mid 1960s), acquired SGS became the most frequent cause of laryngeal stenosis; unlike congenital SGS, it does not improve with time. Laryngeal reconstruction surgery evolved as a consequence of the need to manage these otherwise healthy but tracheotomized children. Ongoing innovations in neonatal care have gradually led to the salvage of premature and medically fragile infants in whom laryngeal pathology is often more severe, and in whom stenosis often involves not only the subglottis, but also the supraglottis or glottis-causing significant morbidity and mortality. The primary objective of intervention in these children is decannulation or preventing the need for tracheotomy. The aim of this article is to present a more detailed description of both congenital and acquired SGS, highlighting the essentials of diagnostic assessment and familiarizing the reader with contemporary management approaches.
          Article 0 comments Cited 15 times – based on 0 reviews     Review now
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            Stents for airway strictures: selection and results

            Adil Ayub, Adnan Al-Ayoubi, Faiz Y. Bhora (2017)
            Airway stents can provide effective and timely relief in patients with central airway obstruction. Silicone based stents are the most commonly used airway stents worldwide with a long track record of safety. Metallic stents continue to evolve from the earliest uncovered versions to a variety of newly designed covered stents. Despite the availability of a variety of stent materials and designs, minimal advances have been made towards innovation in stent technology and an ideal stent has unfortunately not yet been developed. Nevertheless, the first generation of biodegradable airway stents are available, work on drug-eluted stents is in the pipeline and three-dimensional printing of a customized airway stent may be the future. In this review, we discuss selection and results for most commonly utilized airway stents.
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              Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

              I Sehgal, S. Dhooria, A. Bal … (2016)
              Article 0 comments Cited 11 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Autops Case Rep
                Journal ID (iso-abbrev): Autops Case Rep
                Journal ID (publisher-id): autopsy
                Title: Autopsy & Case Reports
                Publisher: São Paulo, SP: Universidade de São Paulo, Hospital Universitário
                ISSN (Electronic): 2236-1960
                Publication date (Electronic): 14 January 2019
                Publication date Collection: Jan-Mar 2019
                Volume: 9
                Issue: 1
                Electronic Location Identifier: e2018072
                Affiliations
                [a ]Clinica Multiperfil, General Surgery Service .Luanda,Angola.
                [b ]Universidade de São Paulo (USP), Hospital Universitário, Surgery Division .São Paulo, SP,Brazil.
                [c ]Universidade de São Paulo (USP), Heart Institute, Thoracic Surgery Service .São Paulo, SP,Brazil.
                Author notes

                Authors’ contributions: All authors contributed equally in the article’s preparation. Gaspar MTC wrote the manuscript and researched the literature. Maximiano LF performed the anti-reflux surgery. Minamoto H and Otoch JP performed the endotracheal procedures. All authors proofread and collectively approved the manuscript for publication.

                The authors retain the informed consent signed by the patient and have the approval of the Institutional Ethics committee.

                Conflict of interest: None

                Correspondence
Márcio Teodoro da Costa Gaspar
Clinica Multiperfil
Rua Morro Bento, s/n – Samba / Luanda – Angola
Phone: +244 923680961
 marcio85gaspar@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-5439-7328
                Article
                Publisher ID: autopsy-09-01e2018072
                DOI: 10.4322/acr.2018.072
                PMC ID: 6394355
                PubMed ID: 30863738
                SO-VID: e41cfa56-2e52-407b-9bce-9990f5a6c94b
                Copyright © Autopsy and Case Reports. ISSN 2236-1960. Copyright © 2019.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the article is properly cited.

                History
                Date received : 06 April 2018
                Date accepted : 08 October 2018
                Page count
                Figures: 6, Tables: 0, Equations: 0, References: 18
                Categories
                Subject: Article / Clinical Case Report

                Keywords: tracheal stenosis,intubation, endotracheal,prosthesis implantation
                Data availability:
                Keywords: tracheal stenosis, intubation, endotracheal, prosthesis implantation

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