Conservative Treatment of Neonatal Pneumomediastinum With Subcutaneous Emphysema Due To Airway Injury

Yıl 2013, , 71 - 73, 01.02.2013

Dilek Kahvecioğlu Serdar Alan Gülnur Göllü Ömer Erdeve Begüm Atasay Murat Çakmak Saadet Arsan

https://doi.org/10.1501/Tipfak_0000000844

Öz

Tracheal injury is an uncommon especially in neonates, and urgent recognition and management are needed because of its life-threatening complications. Here we present a- 2160 g-female newborn with 342/7 weeks gestation who sustained tracheal rupture following intubation for surfactant administration and treated with conservative management. Successful conservative management of tracheal perforation in infants involves the placement of uncuffed tubes distal to injury, holding of oral feeds and broad-spectrum antibiotics prophylaxis. Conservative management should be considered, especially in patient who has stable vital signs

Anahtar Kelimeler

Newborn, tracheal injury, pneumomediastinum, subcutaneous emphysemia

Havayolu Hasarına Bağlı Olușan Pnömomediastinum ve Subkutan Amfizemli Bir Yenidoğanda Konservatif Tedavi

Öz

Newborn, tracheal injury, pneumomediastinum, subcutaneous emphysemia. Trakeal hasarlanma özellikle yenidoğanlarda nadir görülür ve hayatı tehdit eden komplikasyonları nedeniyle acil tanı ve tedavi gerektirir. Biz de bu makalede 342/7 haftada, 2160 gr doğan, surfaktan tedavisi verilmesi sırasında trakeal rüptür gelișen ve konservatif tedaviyle iyileșen bir kız yenidoğan olgusunu sunmayı amaçladık. Trakeal perforasyon gelișen yenidoğanlarda konservatif tedavide hasarlı bölgenin ilerisine endotrakeal tüp yerleștirilmesi, oral beslenmenin kesilmesi ve antibiyotik profilaksisi yer alır. Stabil vital bulguları olan hastalarda konservatif tedavi göz önünde bulundurulmalıdır.

Anahtar Kelimeler

Yenidoğan, trakeal hasarlanma, pnömomediastinum, subkutan amfizem

Kaynakça

• 1- Mendez R, Pensado A, Tellado M, et al Management of massive air leak following intubation injury in a very low birth weight infant. Br J Anaesth.2002;88:722-724.
• 2- Doherty KM, Tabaee A, Castillo M, et al. Neonatal tracheal rupture complicating endotracheal intubation: a case report and indications for conservative management. Int J Pediatr Otorhinolaryngol 2005;69:111-116.
• 3- Goudy SL, Miller FB, Bumpous JM. Neck crepitance: evaluation and management of suspected upper aerodigestive tract injury. Laryngoscope. 2002;112:791-795.
• 4- Schuman TA, Jacobs B, Walsh W, Goudy SL. Iatrogenic perinatal pharyngoesophageal injury: a disease of prematurity. Int J Pediatr Otorhinolaryngol. 2010;74:393-397.
• 8- Jo YY, Park WY, Choi E, Koo BN,
• 5- Krause MF, Hoehn T. Partial transsection of the neonatal trachea. Resusitation. 1998;38:43-46.
• 6- Wei JL, Bond J. Management and prevention of endotracheal intubation injury in neonates. Curr Opin Otolaryngol Head Neck Surg. 2011;19:474-477.
• 7- Kacmarynski DSF, Sidman JD, Rimell FL, Hustead VA. Spontaneous tracheal and subglottic tears in neonates. Laryngoscope. 2002;112:1387–1393. Kil HK. Delayed detection of subcutaneous emphysema following routine endotracheal intubation Korean J Anesthesiol 2010;59:220-223.
• 9- Watters KF, Lacy PD, Walsh RM. Massive subcutaneous emphysema following routine endotracheal intubation. J Laryngol Otol 2003;117:899-901.