Extensive Tracheal Injuries: A Reasoned Multistep Approach to Guarantee Mechanical Ventilatory Support Developed During the COVID-19 Pandemic.
Francesco MattioliAndrea MartoneAlessandro AndreaniGaia CappielloRoberto TonelliEnrico CliniAlessandro MarchioniPublished in: OTO open (2022)
The COVID-19 pandemic has notably increased the need for prolonged mechanical ventilation (MV) in patients with respiratory failure. This has increased the risk of extensive tracheal injury (ETI) associated with life-threatening complications in complex cases. Furthermore, tracheal injury treatment in patients with COVID-19 has not been described yet. Three patients with COVID-19 and ETI who required MV between April and November 2020 were included. A multistep approach was performed to restore tracheal integrity with a custom-remodeled stent and tracheostomy tube placement to allow ventilatory support. Efficient MV with no residual air leaks was obtained in all cases. One patient died 6 weeks after the procedure due to COVID-19 lung damage. Two patients have completely been weaned from MV. This multistep procedure could be used to maintain ventilatory support in the case of ETI, working as a bridge to subsequent surgery when clinical conditions improve.
Keyphrases
- mechanical ventilation
- respiratory failure
- acute respiratory distress syndrome
- minimally invasive
- intensive care unit
- end stage renal disease
- extracorporeal membrane oxygenation
- newly diagnosed
- coronavirus disease
- ejection fraction
- sars cov
- oxidative stress
- case report
- coronary artery bypass
- peritoneal dialysis
- risk factors
- patient reported outcomes
- acute coronary syndrome
- patient reported
- respiratory syndrome coronavirus