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Postgraduate medicine · Jun 2021
Case ReportsAnesthetic consideration for airway management in patient undergoing tracheal resection and reconstruction for severe postintubation tracheal stenosis: a case report.
- Yi Chen, Hong Liao, Yuanyuan Niu, Xinli Ni, and Jianzhen Wang.
- Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
- Postgrad Med. 2021 Jun 1; 133 (5): 544-547.
AbstractIntroduction Severe postintubation tracheal stenosis (PITS) is a rare iatrogenic complication after endotracheal intubation.Case presentation A case of PITS in a 51-year-old male undergoing partial pericardiectomy with a principal diagnosis of tuberculous constrictive pericarditis. Within 6 hours of extubation, a second emergency intubation lasting 120 hours was performed. The patient reported exertional dyspnea 30 days after discharge. High-resolution tracheobronchial tree computed tomography with three-dimensional reconstruction revealed constriction of the tracheal lumen of more than 80% at the thyroid planar upper third of the trachea. Flexible bronchoscopy revealed a tracheal stenosis located 3-4 cm from the glottis that could not be passed prior to general anesthesia. Mechanical ventilation with a ProSeal laryngeal mask airway (PLMA) and preparation for extracorporeal circulation as a final rescue option were performed to maximize patient safety. The patient underwent a tracheal resection and reconstruction without complications.Conclusion A supraglottic airway mode may be a practical and worthwhile alternative for patients with severe PITS.
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