• Ella Illuzzi, Celia Wells, Anna Hackett, Darlene Ricco, Anne Haran, Christal Gittens, Maria Sevillano, Meryl Castro, Eva Develleres, Mardisa Samson Ramos, Ziya Zhang, John Oropello, and Roopa Kohli-Seth.
• Ella Illuzzi is a nurse practitioner in the transplant intensive care unit at Mount Sinai Hospital, New York, New York.
• Crit Care Nurse. 2022 Jun 1; 42 (3): 12-18.

IntroductionCertain airway disorders, such as tracheal stenosis, can severely affect the ability to breathe, reduce quality of life, and increase morbidity and mortality. Treatment options for long-segment tracheal stenosis include multistage tracheal replacement with biosynthetic material, autotransplantation, and allotransplantation. These interventions have not demonstrated long-term dependable results because of lack of adequate blood supply to the organ and ciliated epithelium. A new transplant program featuring single-stage long-segment tracheal transplant addresses this concern.Clinical FindingsThe patient was a 56-year-old woman with a history of obesity, type 2 diabetes, hypertension, hyperlipidemia, liver sarcoidosis, 105-pack-year smoking history, and asthma. A severe asthma exacerbation in 2014 required prolonged intubation, and she subsequently developed long-segment cricotracheal stenosis. In 2015 she underwent an unsuccessful tracheal resection followed by failed attempts at tracheal stenting and dilation procedures. These attempts at stenting resulted in a permanent extended-length tracheostomy and ultimately ventilator dependency.InterventionsThe patient underwent a single-stage long-segment deceased donor tracheal transplant. Important nursing considerations included hemodynamic monitoring, airway management and securement, graft assessment, stoma and wound care, nutrition, medication administration, and patient education.ConclusionHigh-quality nursing care postoperatively in the intensive care unit is critical to safe and effective treatment of the tracheal transplant recipient and success of the graft. To effectively treat these patients, nurses need relevant education and training. This article is the first documentation of postoperative nursing care following single-stage long-segment tracheal transplant.©2022 American Association of Critical-Care Nurses.

38 keywords...

hide…