Cargando…
Post-intubation tracheal lacerations: Risk-stratification and treatment protocol according to morphological classification
BACKGROUND: Post-intubation tracheal laceration (PITL) is a rare condition (0.005% of intubations). The treatment of choice has traditionally been surgical repair. Following our first report in 2010 of treatment protocol tailored to a risk-stratified morphological classification there is now clear e...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727090/ https://www.ncbi.nlm.nih.gov/pubmed/36504581 http://dx.doi.org/10.3389/fsurg.2022.1049126 |
Sumario: | BACKGROUND: Post-intubation tracheal laceration (PITL) is a rare condition (0.005% of intubations). The treatment of choice has traditionally been surgical repair. Following our first report in 2010 of treatment protocol tailored to a risk-stratified morphological classification there is now clear evidence that conservative therapy represents the gold standard in the majority of patients. In this paper we aim to validate our risk-stratified treatment protocol through the largest ever reported series of patients. METHODS: This retrospective analysis is based on a prospectively collected series (2003–2020) of 62 patients with PITL, staged and treated according to our revised morphological classification. RESULTS: Fifty-five patients with Level I (#8), II (#36) and IIIA (#11) PITL were successfully treated conservatively. Six patients with Level IIIB injury and 1 patient with Level IV underwent a surgical repair of the trachea. No mortality was reported. Bronchoscopy confirmed complete healing in all patients by day 30. Statistical analysis showed age only to be a risk factor for PITL severity. CONCLUSIONS: Our previously proposed risk-stratified morphological classification has been validated as the major tool for defining the type of treatment in PITL. |
---|