JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Beiderlinden, M. Articles by Peters, J. Search for Related Content PubMed PubMed Citation Articles by Beiderlinden, M. Articles by Peters, J. Related Collections Critical Care Airway Complications

---

REVIEW ARTICLE

Conservative Treatment of Tracheal Injuries

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany

Address correspondence and reprint requests to Dr. med. Martin Beiderlinden, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstrasse 55, D-45122 Essen, Germany. Address email to martin.beiderlinden{at}uni-essen.de

Tracheal injuries, independent of their origin, may be life-threatening. Surgical repair is regarded as the treatment of choice but has not been compared with other approaches. We hypothesized that defects bridgeable by an artificial airway may enable conservative treatment. We report on five patients with tracheal injuries, two in the trachea’s upper third resulting from trauma and intubation and three in its middle third after percutaneous dilational tracheostomy. Tracheal defects were bridged by endotracheal or tracheostomy tubes under bronchoscopic guidance and the cuff was inflated distal to the lesion. Air leakage stopped immediately and all tracheal defects healed without further interventions. No case of stenosis or mediastinitis was observed. These results suggest that treating tracheal injuries conservatively by placing an artificial airway under bronchoscopic guidance may be effective and offers a convenient starting position for secondary surgical repair in selected patients when conservative treatment fails.

IMPLICATIONS: Bronchoscopic-guided bridging of tracheal tears with an artificial airway is a rapid and easy method to stop immediately life-threatening air leakage. Furthermore, with conservative treatment, tracheal injuries can heal without infectious or stenotic complications. Therefore, conservative treatment should be considered an alternative to surgery in selected patients.

This article has been cited by other articles:

				A. Wurtz, L. Benhamed, M. Conti, and H. Porte Management of postintubation tracheal ruptures J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 231 - 232. [Full Text] [PDF]

				M. Beiderlinden and M. Eikermann The Laryngeal Mask Airway for Airway Management During Percutaneous Tracheostomy: Everything Should Be Made as Simple as Possible but Not Simpler Anesth. Analg., March 1, 2007; 104(3): 743 - 744. [Full Text] [PDF]

				M. Conti, M. Pougeoise, A. Wurtz, H. Porte, F. Fourrier, P. Ramon, and C.-H. Marquette Management of postintubation tracheobronchial ruptures. Chest, August 1, 2006; 130(2): 412 - 418. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999