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Hibino A, Hibino A, Nishimaki H, Denda S. Asymptomatic Subglottic Stenosis Discovered During Anesthesia Induction and Not Predicted by Preoperative Evaluation: A Case Report. Cureus 2024; 16:e59543. [PMID: 38832207 PMCID: PMC11144586 DOI: 10.7759/cureus.59543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
Subglottic stenosis (SGS) can be asymptomatic in cases with slow-growing granulomas. In this study, we report a case of SGS discovered during tracheal intubation for anesthesia induction. A 74-year-old woman was scheduled for surgery under general anesthesia for a left humeral fracture. Resistance was observed when the tracheal tube passed through the glottis, stopping the tube from advancing. We placed a laryngeal mask (LMA) to secure her airway and examined it using a bronchial fiber to detect circumferential stenosis of the subglottis due to granulation. The airway was secured using an LMA instead of intubation, and the patient was successfully managed under anesthesia. Asymptomatic SGS is difficult to detect preoperatively, and anesthesiologists may encounter unexpected intubation issues. LMA is an important tool for an effective strategy to manage intubation difficulties.
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Affiliation(s)
- Ayaka Hibino
- Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, JPN
| | - Akinobu Hibino
- Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, JPN
| | - Hironobu Nishimaki
- Anesthesiology and Pain Clinic Surgery, Niigata City General Hospital, Niigata, JPN
| | - Sadahei Denda
- Anesthesiology and Pain Clinic Surgery, Niigata City General Hospital, Niigata, JPN
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Sharma V, Atluri H. Unveiling the Success of Awake Insertion of Supraglottic Airway Device for Ventilation in the Bronchoscopic Management of Tracheal Stenosis. Cureus 2024; 16:e54703. [PMID: 38524051 PMCID: PMC10960592 DOI: 10.7759/cureus.54703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
Tracheal and subglottic stenoses are inflammatory conditions that can arise from a variety of potential etiologies, most commonly as a result of iatrogenic airway injury due to endotracheal intubation. Significant stenosis requires management by endoscopy or surgical resection. We describe a case of recurrent subglottic cuff stenosis with an episode of sudden desaturation in a 25-year-old female. The management involved balloon dilatation, laser ablation, and topical mitomycin C application through a flexible fiberoptic bronchoscope. Ensuring safe gas exchange during bronchoscopy was a priority, and this was achieved by maintaining ventilation with a supraglottic airway device, which was inserted in an awake patient after adequate tropicalization of the oral cavity. The intervention successfully helped in the management of stenosis and also addressed the complication of sudden complete airway collapse due to sedation.
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Affiliation(s)
- Vipul Sharma
- Anesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Harika Atluri
- Anesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Lee SH, Cho E, Park JH, Lee JY, Hong JH, Han H. Addressing desaturation in a tracheal stenosis patient using the transnasal humidified rapid-insufflation ventilatory exchange technique during tracheostomy: A case report. Medicine (Baltimore) 2023; 102:e34567. [PMID: 37543766 PMCID: PMC10402959 DOI: 10.1097/md.0000000000034567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
RATIONALE Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing the current knowledge gap and exploring its potential for airway management. PATIENT CONCERNS A 63-year-old female with subglottic and tracheal stenoses underwent tracheostomy. Multiple attempts to establish a patent airway were unsuccessful, and oxygen saturation dropped to 56%. DIAGNOSIS Endotracheal tube was directed toward the tracheal wall, causing airway obstruction. INTERVENTIONS THRIVE was administered to the patient. Subsequently, the tube position was adjusted to enhance ventilation. OUTCOMES The patient's oxygen saturation increased to 99%. The postoperative complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium, resolved. The patient was discharged on postoperative day 9. LESSONS THRIVE could be considered a temporary measure to enhance oxygenation before initiating a definitive treatment strategy.
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Affiliation(s)
- Sou Hyun Lee
- Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
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Li JJ, Li N, Ma WJ, Bao MX, Chen ZY, Ding ZN. Safety application of muscle relaxants and the traditional low-frequency ventilation during the flexible or rigid bronchoscopy in patients with central airway obstruction: a retrospective observational study. BMC Anesthesiol 2021; 21:106. [PMID: 33823804 PMCID: PMC8022393 DOI: 10.1186/s12871-021-01321-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background Bronchoscopy treatments of central airway obstruction (CAO) under general anesthesia are high-risky procedures, and posing a giant challenge to the anesthesiologists. We summarized and analyzed our clinical experience in patients with CAO undergoing flexible or rigid bronchoscopy, to estimate the safety of skeletal muscle relaxants application and the traditional Low-frequency ventilation. Methods Clinical data of 375 patients with CAO who underwent urgent endoscopic treatments in general anesthesia from January 2016 to October 2019 were retrospectively reviewed. The use ratio of skeletal muscle relaxants, dose of skeletal muscle relaxants used, the incidence of perioperative adverse events, adequacy of ventilation and gas exchange, post-operative recovery between rigid bronchoscopy and flexible bronchoscopy therapy, and risk factors for postoperative ICU admission were evaluated. Results Of the 375 patients with CAO, 204 patients were treated with flexible bronchoscopy and 171 patients were treated with rigid bronchoscopy. Muscle relaxants were used in 362 of 375 patients (including 313 cisatracurium, 45 rocuronium, 4 atracurium, and 13 unrecorded). The usage rate of muscle relaxants (96.5% in total) was very high in patients with CAO who underwent either flexible bronchoscopy (96.6%) or rigid bronchoscopy (96.5%) therapy. The dosage of skeletal muscle relaxants (Cisatracium) used was higher in rigid bronchoscopy compared with flexible bronchoscopy therapy (10.8 ± 3.8 VS 11.6 ± 3.6 mg, respectively, p < 0.05). No patient suffered the failure of ventilation, bronchospasm and intraoperative cough either in flexible or rigid bronchoscopy therapy. Hypoxemia was occurred in 13 patients (8 in flexible, 5 in rigid bronchoscopy) during the procedure, and reintubation after extubation happened in 2 patients with flexible bronchoscopy. Sufficient ventilation was successfully established using the traditional Low-frequency ventilation with no significant carbon dioxide accumulation and hypoxemia occurred both in flexible and rigid bronchoscopy group (p > 0.05). Three patients (1 in flexible and 2 in rigid) died, during the post-operative recovery, and the higher grade of American Society of Anesthesiologists (ASA) and obvious dyspnea or orthopnea were the independent risk factors for postoperative ICU admission. Conclusion The muscle relaxants and low-frequency traditional ventilation can be safely used both in flexible and rigid bronchoscopy treatments in patients with CAO. These results may provide strong clinical evidence for optimizing the anesthesia management of bronchoscopy for these patients.
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Affiliation(s)
- Jing-Jin Li
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Nan Li
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Wei-Jia Ma
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Ming-Xue Bao
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zi-Yang Chen
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zheng-Nian Ding
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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Kodia K, Liu Y, Ghodsizad A, Turner D, Briski L, Nguyen DM. Use of venovenous extracorporeal membrane oxygenation for resection of a large paratracheal mass causing critical tracheal stenosis: A case report. J Card Surg 2020; 36:367-370. [PMID: 33225496 DOI: 10.1111/jocs.15207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 12/17/2022]
Abstract
Critical airway stenosis is challenging for surgeons and anesthesiologists to secure a reliable airway for ventilation. The use of venovenous (VV)-extracorporeal membrane oxygenation (ECMO) has been described as a strategy to provide adequate gas exchange in such instances. We present a case of a young female with a complex paratracheal mass significantly compressing the trachea; a planned intraoperative VV-ECMO was instituted to allow safe orotracheal intubation of a double-lumen endotracheal tube for lung isolation and tumor resection.
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Affiliation(s)
- Karishma Kodia
- Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Miami, Miami, Florida, USA
| | - Yuda Liu
- Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Miami, Miami, Florida, USA
| | - Ali Ghodsizad
- Division of Cardiothoracic Transplantation, The DeWitt Daughtry Department of Surgery, University of Miami, Miami, Florida, USA
| | - Darren Turner
- Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Miami, Miami, Florida, USA
| | - Laurence Briski
- Department of Pathology, University of Miami, Miami, Florida, USA
| | - Dao M Nguyen
- Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Miami, Miami, Florida, USA
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Zhu GQ, Wu XM, Cao DH. High frequency jet ventilation at the distal end of tracheostenosis during flexible bronchoscopic resection of large intratracheal tumor: Case series. Medicine (Baltimore) 2020; 99:e19929. [PMID: 32569155 PMCID: PMC7310889 DOI: 10.1097/md.0000000000019929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Resection of a large intratracheal tumor with severe obstruction via flexible bronchoscope remains a formidable challenge to anesthesiologists. Many artificial airways positioned proximal to tracheal obstruction can not ensure adequate oxygen supply. How to ensure effective gas exchange is crucial to the anesthetic management. PATIENT CONCERNS Five patients of intratracheal tumor occupying 70% to 85% of the tracheal lumen were scheduled for tumor resection via flexible bronchoscope. DIAGNOSIS The patients were diagnosed with intratracheal tumor based on their symptoms, radiographic findings and tracheoscopy. INTERVENTIONS We describe a technique of high frequency jet ventilation (HFJV) using an endobronchial suction catheter distal to tracheostenosis during the surgery, which ensured the good supply of oxygen. We applied general anesthesia with preserved spontaneous breathing. A comprehensive anesthesia protocol that emphasizes bilateral superior laryngeal nerve (SLN) block and sufficient topical anesthesia. An endobronchial suction catheter was introduced transnasally into the trachea and then advanced through the tracheostenosis with the tip proximal to the carina under direct vision with the aid of fiber bronchoscope. HFJV was then performed through the suction catheter. OUTCOMES The SPO2 maintained above 97% during the surgery. Carbon dioxide retention was alleviated obviously when adequate patency of the trachea lumen achieved about 30 min after the beginning of surgery. HFJV was ceased and all patients had satisfactory spontaneous breathing at the end of the procedure. CONCLUSION HFJV at the distal end of tracheostenosis is a suitable ventilation strategy during flexible bronchoscopic resection of a large intratracheal tumor.
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Affiliation(s)
| | - Xiao-Mai Wu
- Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China
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Tsuji T, So M, Sobue K. Subglottic stenosis due to an unexpected foreign body diagnosed after emergency tracheostomy in a child. JA Clin Rep 2019; 5:46. [PMID: 32026088 PMCID: PMC6966935 DOI: 10.1186/s40981-019-0268-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Subglottic stenosis is a known complication of traumatic and prolonged endotracheal intubation. It is rare that the causes of severe subglottic stenosis are revealed to be an unexpected foreign body after airway securement in a child. Subglottic stenosis in a child is often associated with airway emergency, and management of difficult airway may be required. CASE PRESENTATION We report the case of an 8-year-old girl with severe subglottic stenosis who required emergency tracheostomy. Emergency tracheostomy was performed under regional anesthesia. Sevoflurane was administered with sufficient titration to maintain spontaneous breathing. At first, the cause of severe subglottic stenosis was thought to be a traumatic event that had occurred 1 month previously; however, subsequent laryngoscopy revealed that the cause of subglottic stenosis was a foreign body. CONCLUSIONS Management of the airway in a child with severe subglottic stenosis should be selected according to each patient's individual circumstances.
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Affiliation(s)
- Tatsuya Tsuji
- Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
| | - MinHye So
- Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Kazuya Sobue
- Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
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The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review. Can J Anaesth 2018; 65:685-697. [DOI: 10.1007/s12630-018-1099-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/15/2022] Open
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9
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Tracheal resection with regional anesthesia. J Clin Anesth 2014; 26:697-8. [DOI: 10.1016/j.jclinane.2014.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 09/29/2014] [Accepted: 10/02/2014] [Indexed: 11/21/2022]
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Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R, Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT. The difficult airway with recommendations for management--part 2--the anticipated difficult airway. Can J Anaesth 2013; 60:1119-38. [PMID: 24132408 PMCID: PMC3825645 DOI: 10.1007/s12630-013-0020-x] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 08/13/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Appropriate planning is crucial to avoid morbidity and mortality when difficulty is anticipated with airway management. Many guidelines developed by national societies have focused on management of difficulty encountered in the unconscious patient; however, little guidance appears in the literature on how best to approach the patient with an anticipated difficult airway. METHODS To review this and other subjects, the Canadian Airway Focus Group (CAFG) was re-formed. With representation from anesthesiology, emergency medicine, and critical care, CAFG members were assigned topics for review. As literature reviews were completed, results were presented and discussed during teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made, and levels of evidence were assigned. PRINCIPAL FINDINGS Previously published predictors of difficult direct laryngoscopy are widely known. More recent studies report predictors of difficult face mask ventilation, video laryngoscopy, use of a supraglottic device, and cricothyrotomy. All are important facets of a complete airway evaluation and must be considered when difficulty is anticipated with airway management. Many studies now document the increasing patient morbidity that occurs with multiple attempts at tracheal intubation. Therefore, when difficulty is anticipated, tracheal intubation after induction of general anesthesia should be considered only when success with the chosen device(s) can be predicted in a maximum of three attempts. Concomitant predicted difficulty using oxygenation by face mask or supraglottic device ventilation as a fallback makes an awake approach advisable. Contextual issues, such as patient cooperation, availability of additional skilled help, and the clinician's experience, must also be considered in deciding the appropriate strategy. CONCLUSIONS With an appropriate airway evaluation and consideration of relevant contextual issues, a rational decision can be made on whether an awake approach to tracheal intubation will maximize patient safety or if airway management can safely proceed after induction of general anesthesia. With predicted difficulty, close attention should be paid to details of implementing the chosen approach. This should include having a plan in case of the failure of tracheal intubation or patient oxygenation.
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Affiliation(s)
- J Adam Law
- Department of Anesthesia, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax Infirmary Site, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada,
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Chang X, Zhang X, Li X, Xu M, Zhao H, Fang W, Yao F. Use of extracorporeal membrane oxygenation in tracheal surgery: a case series. Perfusion 2013; 29:159-62. [PMID: 23928316 DOI: 10.1177/0267659113497072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To review our experience of extracorporeal membrane oxygenation in airway management during tracheal surgery. METHODS A retrospective, observational study was conducted to evaluate the effectiveness of extracorporeal membrane oxygenation in tracheal surgery in Shanghai Chest Hospital between 2008 and 2012. RESULTS In all 91 tracheal surgeries, 7 high-risk cases used extracorporeal membrane oxygenation. The duration of extracorporeal membrane oxygenation support ranged from 10 min to 31 min. All extracorporeal membrane oxygenation patients underwent surgical procedures safely and there was no hospital mortality. CONCLUSIONS Although various advanced anesthesia techniques can ensure a safe airway in tracheal surgery in most cases, extracorporeal circulation plays an important role in high-risk cases.
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Affiliation(s)
- X Chang
- 1Department of Extracorporeal Circulation, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
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12
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Fatimi SH, Qasim Raza M, Ghani A, Shah N, Ashfaq A. Tracheal reconstruction for comlex acute tracheal stenosis. Ann Med Surg (Lond) 2013; 2:57-9. [PMID: 25628886 PMCID: PMC4306099 DOI: 10.1016/s2049-0801(13)70038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 02/17/2013] [Indexed: 11/16/2022] Open
Abstract
Tracheal stenosis refers to a reduction in the size of the tracheal lumen and can be due to a myriad of reasons, but the most common remains trauma. In iatrogenic situations, internal trauma is the most likely culprit, resulting from prolonged intubation. Our case reviews a patient who developed severe tracheal stenosis (90% reduction in lumen size) within a month of a threeday- long intubation, and presented to the emergency room with dyspnea, orthopnea, and stridor. Tracheal reconstruction with resection of the stenosed segment and end-to-end anastomosis was done. The patient returned a month later with re-stenosis, and underwent tracheal dilatation. Subsequently, he was discharged with a tracheostomy with no problems thereafter.
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Affiliation(s)
- Saulat H Fatimi
- Department of Surgery, Mayo Clinic Arizona, Arizona, United States of America
| | - M Qasim Raza
- Department of Surgery, Mayo Clinic Arizona, Arizona, United States of America
| | - Alina Ghani
- Department of Surgery, Mayo Clinic Arizona, Arizona, United States of America
| | - Nilay Shah
- Division of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Pakistan
| | - Awais Ashfaq
- Division of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Pakistan
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13
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Parker JD. Unexpected Obstruction of a Parker Flex-Tip™ Tracheal Tube in a Patient with Subglottic Stenosis. Anesth Analg 2008. [DOI: 10.1213/ane.0b013e31817110db] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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14
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Adwan H, Wigfield CH, Clark S, Barnard S. Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review. J Cardiothorac Surg 2008; 3:27. [PMID: 18462499 PMCID: PMC2409331 DOI: 10.1186/1749-8090-3-27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2008] [Accepted: 05/07/2008] [Indexed: 11/06/2022] Open
Abstract
The use of cardiopulmonary bypass as an adjunct to airway surgery for non-malignant diseases in adults is not well established in the UK. We are reporting two cases which demonstrate the additional benefits of using cardiopulmonary bypass during difficult bronchoscopy and complex airway stenting. The first case presents an emergency indication for cardiopulmonary bypass in a life-threatening but benign condition. The second case presented, utilises cardiopulmonary bypass standby as adjunct to a potentially life threatening procedure. A review of the literature is also provided.
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Affiliation(s)
- Hussamuddin Adwan
- Department of Anatomy and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK.
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15
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Laoutid J, Zidouh S, Meziane M, Htit A, Drissi Kamili N. [Airway management for acute respiratory distress in a patient with severe tracheal stenosis]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2008; 27:108-109. [PMID: 18164581 DOI: 10.1016/j.annfar.2007.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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