Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment

Journal of Cardiothoracic Surgery

Dimitrios Dougenis²  Kriton Filos¹  Fotini Fligou¹  Panagiotis Dedeilias³  Efstratios N Koletsis²  Christos Prokakis² 

[1] Department of Anesthesiology and Intensive Care, University of Patras, School of Medicine, Patras, Greece;Department of Cardiothoracic Surgery, University of Patras, School of Medicine, Patras, Greece;Department of Cardiothoracic Surgery, Evaggelismos Hospital, Athens, Greece

关键词: Delayed presentation;    Conservative;    Surgery;    Primary repair;    Bronchoscopy;    Airway;    Injury;    Trachea;   

Others  :  1152315
DOI  :  10.1186/1749-8090-9-117

 received in 2014-04-13, accepted in 2014-06-23,  发布年份 2014

【 摘 要 】

Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury. Bronchoscopy and chest computed tomography with MPR and 3D reconstruction of the airway represent the procedures of choice for the definitive diagnosis. Endotracheal intubation under bronchoscopic guidance is the key point to gain airway control and appropriate ventilation. Primary repair with direct suture or resection and an end to end anastomosis is the treatment of choice for patients suffering from tracheobronchial injuries (TBI). The surgical approach to the injured airway depends on its location. Selected patients, mainly with iatrogenic injuries, can be treated conservatively as long as the injury is small (<2 cm), a secure and patent airway and adequate ventilation are achieved, and there are no signs of sepsis. Patients with delayed presentation airway injuries should be referred for surgical treatment. Intraoperative evaluation of the viability of the lung parenchyma beyond the site of stenosis/obstruction is mandatory to avoid unnecessary lung resection.

【 授权许可】

   
2014 Prokakis et al.; licensee BioMed Central Ltd.

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