Search Our Scientific Publications & Authors

Publications
find publications by category +
Translate page:

Tracheal stenosis in prolonged mechanically ventilated patients: prevalence, risk factors, and bronchoscopic management.

Authors:
Alessandro Ghiani Konstantinos Tsitouras Joanna Paderewska Dieter Munker Swenja Walcher Claus Neurohr Nikolaus Kneidinger

BMC Pulm Med 2022 Jan 6;22(1):24. Epub 2022 Jan 6.

Department of Internal Medicine V, Ludwig-Maximilians-University (LMU) of Munich, Munich, Germany.

Background: Various complications may arise from prolonged mechanical ventilation, but the risk of tracheal stenosis occurring late after translaryngeal intubation or tracheostomy is less common. This study aimed to determine the prevalence, type, risk factors, and management of tracheal stenoses in mechanically ventilated tracheotomized patients deemed ready for decannulation following prolonged weaning.

Methods: A retrospective observational study on 357 prolonged mechanically ventilated, tracheotomized patients admitted to a specialized weaning center over seven years. Flexible bronchoscopy was used to discern the type, level, and severity of tracheal stenosis in each case. We described the management of these stenoses and used a binary logistic regression analysis to determine independent risk factors for stenosis development.

Results: On admission, 272 patients (76%) had percutaneous tracheostomies, and 114 patients (32%) presented mild to moderate tracheal stenosis following weaning completion, with a median tracheal cross-section reduction of 40% (IQR 25-50). The majority of stenoses (88%) were located in the upper tracheal region, most commonly resulting from localized granulation tissue formation at the site of the internal stoma (96%). The logistic regression analysis determined that obesity (OR 2.16 [95%CI 1.29-3.63], P < 0.01), presence of a percutaneous tracheostomy (2.02 [1.12-3.66], P = 0.020), and cricothyrotomy status (5.35 [1.96-14.6], P < 0.01) were independently related to stenoses. Interventional bronchoscopy with Nd:YAG photocoagulation was a highly effective first-line treatment, with only three patients (2.6%) ultimately referred to tracheal surgery.

Conclusions: Tracheal stenosis is commonly observed among prolonged ventilated patients with tracheostomies, characterized by localized hypergranulation and mild to moderate airway obstruction, with interventional bronchoscopy providing satisfactory results.

Download full-text PDF

 Source
http://dx.doi.org/10.1186/s12890-022-01821-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740413PMC
January 2022

Publication Analysis

Top Keywords

tracheal stenosis
16
risk factors
12
mechanically ventilated
12
tracheotomized patients
8
regression analysis
8
logistic regression
8
ventilated tracheotomized
8
prolonged mechanically
8
tracheal
7
patients
5
years flexible
4
admitted specialized
4
tracheostomies 114
4
percutaneous tracheostomies
4
76% percutaneous
4
patients 76%
4
272 patients
4
admission 272
4
developmentresults admission
4
stenosis developmentresults
4

Keyword Occurance

Similar Publications

Respiratory viruses among pediatric inpatients with acute lower respiratory tract infections in Jinan, China, 2016-2019.

Authors:
Fu-Lu Chu Chen Li Li Chen Bo Dong Yang Qiu Yiqing Liu

J Med Virol 2022 May 20. Epub 2022 May 20.

Department of Clinical Laboratory, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, PR China.

The viral etiologies responsible for acute lower respiratory tract infections (ALRI) are a major cause of pediatric hospitalization, and some develop severe diseases requiring pediatric intensive care unit (PICU) admission. The aim of this study was to determine the prevalence of viruses and risk factors associated with PICU admission among patients hospitalized for ALRI. Nasopharyngeal swabs were collected to detect human rhinovirus (HRV), influenza A and B viruses (IAV, IBV), parainfluenza viruses (PIV), and respiratory syncytial virus (RSV) by reverse transcription-polymerase chain reaction (RT-PCR) and adenovirus (ADV) by PCR. Read More

View Article and Full-Text PDF
May 2022
Similar Publications

A Fractured Tracheostomy Tube Causing Airway Compromise.

Authors:
Carlyn Atwood Seckin O Ulualp Galit Kastner Ungar

Am J Case Rep 2022 May 20;23:e936072. Epub 2022 May 20.

Division of Pediatric Anesthesiology, Children's Health System of Dallas, Dallas, TX, USA.

BACKGROUND A wide variety of emergency scenarios associated with tracheostomy tubes have been reported in patients with complex airway disease. Fracture of a tracheostomy tube is a rare complication with a potential for catastrophic outcome. The aim of this case report is to present clinical features and management of airway compromise due to a fractured tracheostomy tube in a patient with subglottic and tracheal stenosis. Read More

View Article and Full-Text PDF
May 2022
Similar Publications

Clinical Implications of Airway Anomalies and Stenosis in Patients with Heterotaxy Syndrome.

Authors:
Ching-Chia Wang Mei-Hwan Wu En-Ting Wu Frank Lu Shyh-Jye Chen

Pediatr Pulmonol 2022 May 18. Epub 2022 May 18.

Department of Radiology, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.

In heterotaxy syndrome, bronchopulmonary situs usually reflects atrial situs, resulting in either right (RAI) or left atrial isomerism (LAI). This study determines airway anomalies and its implications in patients with heterotaxy. This retrospective study included 223 patients with heterotaxy syndrome who received an integrated cardiac computed tomography evaluation. Read More

View Article and Full-Text PDF
May 2022
Similar Publications

Tracheal stenosis as a complication of prolonged intubation in coronavirus disease 2019 (COVID-19) patients: a Peruvian cohort.

Authors:
José Manuel Palacios David Arturo Bellido Fernando Benjamín Valdivia Pamela Alejandra Ampuero Carlos Felipe Figueroa Christian Medina Jorge Edgardo Cervera

J Thorac Dis 2022 Apr;14(4):995-1008

Service of Thoracic Surgery, Guillermo Almenara Irigoyen National Hospital, Lima, Peru.

Background: Tracheal stenosis (TS) is associated with prolonged intubation and inflammation due to coronavirus disease 2019 (COVID-19) infection. Because of the COVID-19 pandemic, longer times of mechanical ventilation have been required, and different tracheostomies beyond 10 to 12 days have been made. All of these have increased the number of cases and complexity of tracheal pathology in patients with severe COVID-19 infection. Read More

View Article and Full-Text PDF
April 2022
Similar Publications

A large intrathoracic goiter with tracheal stenosis: Complete resection using a robot-assisted thoracoscopic approach.

Authors:
Ryuji Nakamura Katsuhiro Okuda Kensuke Chiba Takuya Matsui Risa Oda Tsutomu Tatematsu Keisuke Yokota Ryoichi Nakanishi

Thorac Cancer 2022 May 13. Epub 2022 May 13.

Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Growing intrathoracic goiters may compress surrounding organs and deteriorate the cardiopulmonary function. Treating such cases requires carefully considering how to maintain oxygenation and resect the tumor with minimal invasiveness without complications. We herein report a surgically resected case of a large intrathoracic goiter-compressed trachea extending from the right lower pole of the thyroid gland to the carina. Read More

View Article and Full-Text PDF
May 2022
Similar Publications
}