Chest
Original Research: CRITICAL CARE MEDICINEManagement of Postintubation Tracheobronchial Ruptures
Section snippets
Setting
This study took place in the emergency and critical care department and the department of thoracic surgery and respiratory diseases of a university-affiliated hospital that serves as a referral trauma center for a region of 4 million inhabitants.
Study Population and Inclusion Criteria
All patients with TBR complicating endotracheal intubation between June 1993 and July 2005 entered the study. Excluded were tracheobronchial injuries complicating blunt chest trauma, tracheostomy, rigid bronchoscopy, or thoracic surgery.
Procedures and Protocol
All patients
RESULTS
Thirty consecutive patients with TBR entered the study (26 women and 4 men; mean age, 63 ± 13.3 years; range, 31 to 79 years). All had undergone single-lumen tube endotracheal intubation for elective surgical operations (n = 16) or for emergency intubation for respiratory distress or cardiopulmonary resuscitation (n = 14). No patient was receiving long-term ventilation. Intubation was reported to be difficult in nine occasions, and a stylet was used in three occasions.
Subcutaneous emphysema was
DISCUSSION
This study describes our experience in a series of 30 consecutive patients with iatrogenic tracheobronchial injuries. All but two patients were managed without direct repair of the rupture. More than three fourths of the patients, including those with large and full-thickness lacerations, recovered completely. The outcome in this series of patients compares favorably with data reported in the literature.123456789182021
Surgical repair has traditionally been considered as the cornerstone of
ACKNOWLEDGMENT
We are grateful to Alain Tremblay, MDCM, University of Calgary, Canada, for editorial assistance.
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The authors report that they have no conflicts of interest related to this paper.