Öz
Abstract
Tracheal tear is an uncommon but a serious injury that may be lethal because of the difficulties of accurate anatomical diagnosis and perioperative airway management. A high degree of suspicion is essential to identify these cases and early intervention is associated with better outcome. The anaesthesiologist managing such a case should be aware of the difficulties during securing the airway and during repair of trachea. Proper planning and keeping back up plans ready helps in successful management of these patients. The anaesthetic management needs to be modified during repair of the trachea by using total intravenous anaesthesia and insertion of an endotracheal tube in the trachea distal to the tear.
Keywords: Tracheal tear, anaesthetic management, airway
Özet
Trakeal yırtık nadir ancak doğru anatomik tanımlama ve perioperatif havayolu yönetimindeki güçlükler nedeniyle ölümcül olabilecek kadar ciddi bir hasardır. Bu vakaların tanınmasında yüksek klinik şüphe gerekir ve erken müdahale ile tedavi sonuçları daha iyidir. Anestezist, havayolunun güvenliği ve trakeanın tamiri sırasındaki güçlüklerin farkında olarak bu tür hastaları tedavi etmelidir. Uygun planlama ve yedek planların oluşturulmasıyla bu tür hastalar başarılı bir şekilde tedavi edilebilirler. Trakeanın tamiri sırasında, total intravenöz anestezi uygulanıp yırtığın distalindeki trakeaya endotrakeal tüp yerleştirilirken anestezik tedavinin modifiye edilmesi gerekmektedir.
Anahtar sözcükler: Trakeal yırtık, anestezik tedavi, havayolu
Anahtar Kelimeler
Kaynakça
- Natarajan A, Sanders GM, Bosnac, Sadhahalli. A case of anterior tracheal rupture following trivial trauma. Chest Medicine 2006; pp: 1-5.
- Chen JD, Shanmuganathan K, Mirvis SE, Killeen KL, Dutton RP. Using CT to diagnose tracheal rupture. AJR Am Roentgenol 2001; 176: 1273-80.
- Devitt JH, Boulanger BR. Lower airway injuries and anaesthesia. Can J Anesth 1996; 43: 148-59.
- Fraser RS, Muller NL, Coleman N. Fractures of the trachea and bronchi. In: Diagnosis of diseases of the chest. 4th ed. WB Saunders Co; 1999: 2618-23.
- Fraser RS, Muller NL, Coleman N. Fractures of the trachea and bronchi. In: Diagnosis of diseases of the chest. 4th ed. WB Saunders Co; 1999: 2692-5.
- Harvey-Smith W, Bush W, Northrop C. Traumatic bronchial rupture. AJR Am J Roentgenol 1980; 134: 1189-93.
- Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin 2007; 17: 35-46.
- Barmada H, Gibbons JR. Tracheobronchial injury in blunt and penetrating chest trauma. Chest 1994; 106: 74-8.
- Lobato EB, Risley WP 3rd, Stoltzfus DP. Intraoperative management of distal tracheal rupture with selective bronchial intubation. J Clin Anesth 1997; 9: 155-8.
- Sengupta S, Saikia A, Ramasubban S, Gupta S, Maitra S, Rudra A, Maitra G. Anaesthetic management of a patient with complete tracheal rupture following blunt chest trauma. Ann Card Anaesth 2008; 11: 123-6.
- Newton JR Jr, Sharma R, Azar H, Rummel MC, Britt LD. Successful reconstruction of a complex traumatic carinal disruption. Ann Thorac Surg 1996; 62: 284-6.
- Barrett E. Management of a traumatic tracheal tear: a case report. AANA J 2011; 79: 468-70.
- Wilson WC. Trauma: airway management. ASA difficult airway algorithm modified for trauma and five common trauma intubation scenarios. ASA Newsletter; 2005; 69: 9-16.
- Kaplan JA. Trachestomy and tracheal reconstruction. In: Kaplan JA, (Ed) Thoracic anaesthesia. 2nd ed. New York, Churchill Livingstone, 1991; pp: 441- 61.
- Wilson WC. Shock management. In: Smith CE, (Ed) Trauma anaesthesia. Cambridge, NY: Cambridge University Press; 2008; 44-6.
- Lal AB, Kumar N, Sami KA. Tension pneumoperitoneum from tracheal tear during pharyngolaryngoesophagectomy. Anesth Analg 1995; 80; 408-9.
- Sun KO. Airway management for tracheal tear. Br J Anaesth 1995; 74: 347.
- Mitchell JB, Ward PM. The management of tracheal rupture using bilateral bronchial intubation. Anaesthesia 1993; 48: 223-5.
- El-Baz N, Holinger L, El-Ganzouri A, Gottschalk W, Ivankovich AD. High- frequency positive-pressure ventilation for tracheal reconstruction supported by tracheal T-tube. Anesth Analg 1982; 61: 796-800.
- Yamazaki M, Sasaki R, Masuda A, Ito Y. Anesthetic management of complete tracheal disruption using percutaneous cardiopulmonary support system. Anesth Analg 1998; 86: 998-1000.
- Robbins J, Gensler G, Hind J, Logemann JA, Lindblad AS, Brandt D, Baum H, Lilienfeld D, Kosek S, Lundy D, Dikeman K, Kazandjian M, Gramigna GD, McGarvey-Toler S, Miller Gardner PJ. Comparison of 2 interventions for liquid aspiration on pneumonia incidence: a randomized trial. Ann Intern Med 2008; 148: 509-18.
- Holzki J, Laschat M, Puder C. I atrogenic damage to the pediatric airway. Mechanisms and scar development. Paediatr Anaesth 2009; 19: 131-46.
Öz
Trakeal yırtık nadir ancak doğru anatomik tanımlama ve perioperatif havayolu yönetimindeki güçlükler nedeniyle ölümcül olabilecek kadar ciddi bir hasardır. Bu vakaların tanınmasında yüksek klinik şüphe gerekir ve erken müdahale ile tedavi sonuçları daha iyidir. Anestezist, havayolunun güvenliği ve trakeanın tamiri sırasındaki güçlüklerin farkında olarak bu tür hastaları tedavi etmelidir. Uygun planlama ve yedek planların oluşturulmasıyla bu tür hastalar başarılı bir şekilde tedavi edilebilirler. Trakeanın tamiri sırasında, total intravenöz anestezi uygulanıp yırtığın distalindeki trakeaya endotrakeal tüp yerleştirilirken anestezik tedavinin modifiye edilmesi gerekmektedir
Anahtar Kelimeler
Kaynakça
- Natarajan A, Sanders GM, Bosnac, Sadhahalli. A case of anterior tracheal rupture following trivial trauma. Chest Medicine 2006; pp: 1-5.
- Chen JD, Shanmuganathan K, Mirvis SE, Killeen KL, Dutton RP. Using CT to diagnose tracheal rupture. AJR Am Roentgenol 2001; 176: 1273-80.
- Devitt JH, Boulanger BR. Lower airway injuries and anaesthesia. Can J Anesth 1996; 43: 148-59.
- Fraser RS, Muller NL, Coleman N. Fractures of the trachea and bronchi. In: Diagnosis of diseases of the chest. 4th ed. WB Saunders Co; 1999: 2618-23.
- Fraser RS, Muller NL, Coleman N. Fractures of the trachea and bronchi. In: Diagnosis of diseases of the chest. 4th ed. WB Saunders Co; 1999: 2692-5.
- Harvey-Smith W, Bush W, Northrop C. Traumatic bronchial rupture. AJR Am J Roentgenol 1980; 134: 1189-93.
- Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin 2007; 17: 35-46.
- Barmada H, Gibbons JR. Tracheobronchial injury in blunt and penetrating chest trauma. Chest 1994; 106: 74-8.
- Lobato EB, Risley WP 3rd, Stoltzfus DP. Intraoperative management of distal tracheal rupture with selective bronchial intubation. J Clin Anesth 1997; 9: 155-8.
- Sengupta S, Saikia A, Ramasubban S, Gupta S, Maitra S, Rudra A, Maitra G. Anaesthetic management of a patient with complete tracheal rupture following blunt chest trauma. Ann Card Anaesth 2008; 11: 123-6.
- Newton JR Jr, Sharma R, Azar H, Rummel MC, Britt LD. Successful reconstruction of a complex traumatic carinal disruption. Ann Thorac Surg 1996; 62: 284-6.
- Barrett E. Management of a traumatic tracheal tear: a case report. AANA J 2011; 79: 468-70.
- Wilson WC. Trauma: airway management. ASA difficult airway algorithm modified for trauma and five common trauma intubation scenarios. ASA Newsletter; 2005; 69: 9-16.
- Kaplan JA. Trachestomy and tracheal reconstruction. In: Kaplan JA, (Ed) Thoracic anaesthesia. 2nd ed. New York, Churchill Livingstone, 1991; pp: 441- 61.
- Wilson WC. Shock management. In: Smith CE, (Ed) Trauma anaesthesia. Cambridge, NY: Cambridge University Press; 2008; 44-6.
- Lal AB, Kumar N, Sami KA. Tension pneumoperitoneum from tracheal tear during pharyngolaryngoesophagectomy. Anesth Analg 1995; 80; 408-9.
- Sun KO. Airway management for tracheal tear. Br J Anaesth 1995; 74: 347.
- Mitchell JB, Ward PM. The management of tracheal rupture using bilateral bronchial intubation. Anaesthesia 1993; 48: 223-5.
- El-Baz N, Holinger L, El-Ganzouri A, Gottschalk W, Ivankovich AD. High- frequency positive-pressure ventilation for tracheal reconstruction supported by tracheal T-tube. Anesth Analg 1982; 61: 796-800.
- Yamazaki M, Sasaki R, Masuda A, Ito Y. Anesthetic management of complete tracheal disruption using percutaneous cardiopulmonary support system. Anesth Analg 1998; 86: 998-1000.
- Robbins J, Gensler G, Hind J, Logemann JA, Lindblad AS, Brandt D, Baum H, Lilienfeld D, Kosek S, Lundy D, Dikeman K, Kazandjian M, Gramigna GD, McGarvey-Toler S, Miller Gardner PJ. Comparison of 2 interventions for liquid aspiration on pneumonia incidence: a randomized trial. Ann Intern Med 2008; 148: 509-18.
- Holzki J, Laschat M, Puder C. I atrogenic damage to the pediatric airway. Mechanisms and scar development. Paediatr Anaesth 2009; 19: 131-46.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Derlemeler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Şubat 2012 |
| Yayımlandığı Sayı | Yıl 2012Cilt: 34 Sayı: 2 |