Iyatrojenik post-entübasyon trakea rüptürünün kardiyopulmoner bypass desteği ile cerrahi tedavisi

Öz

Iatrojenik trakeobronşiyal yaralanmaları, endotrakeal entübasyon gibi hava yolu erişimi tekniklerinin ciddi komplikasyonlarındandır. Orotrakeal entübasyon sonrası görülme sıklığı yaklaşık % 0.005’dir. Zaman zaman koruyucu methodlarla tedavi edilseler de çoğu vaka cerrahi yöntemlerle tedavi edilir. Bu olgu sunumunda, 78 yaşındaki bir hastada, entübasyon sonrası meydana gelen geniş membranöz trakea rüptürünün kardiyopulmoner bypass yardımı ile cerrahi tedavisini sunuyoruz. 

Anahtar Kelimeler

• Endotrakeal entübasyon,trakea rupture,kardiyopulmoner baypass

Iatrogenic post-intubation tracheal rupture treated surgically with cardiopulmonary bypass support

Öz

Iatrogenic tracheobronchial injuries are severe complications of airway access techniques such as endotracheal intubation. The reported incidence is approximately 0.005% for orotracheal intubations. Although conservative methods may also be used, surgical intervention is the treatment of choice for most cases. Herein, we present a 78-year old patient with a post-intubation huge membranous tracheal rupture, which was eventually repaired surgically with cardiopulmonary bypass support.

Anahtar Kelimeler

• Endotracheal intubation,trachea rupture,cardiopulmonary bypass

Kaynakça

1. 1. Schneider T, Storz K, Dienemann H, Hoffman H: Management of iatrogenic tracheobronchial injuries: A retrospective analysis of 29 cases. Ann Thorac Surg 2007;83:1960-4
2. 2. Massard G, Rouge C, Dabbagh A, et al. Tracheobronchial lacerations after intubation and tracheostomy. Ann Thorac Surg 1996;61:1483-7.
3. 3. Sahin M, Anglade D, Buchberger M, Jankowski A, Albaladejo P, Ferretti G: Case reports: Iatrogenic bronchial rupture following the use of endotracheal tube introducers. J Can Anesth 2012;59:963-7.
4. 4. Hofmann H, Rettig G, Radke J, Neef H, Silber RE. Iatrogenic ruptures of the tracheobronchial tree. Eur J Cardiothorac Surg 2002;21:649-52.
5. 5. Minambres E, Gonzalez-Castro A, Buron J, Suberviola B, Ballesteros MA, Ortiz-Melon F. Management of postintubation tracheobronchial rupture: our experience and a review of the literature. Eur J Emerg Med 2007;14:177-9.
6. 6. Marty-Ane CH, Picard E, Jonquet O, Mary H. Membranous tracheal rupture after endotracheal intubation. Ann Thorac Surg 1995;60:1367-71.
7. 7. Satyadas T, Nasir N, Erel E, Mudan SS. Iatrogenic tracheal rupture: a novel approach to repair and a review of the literature. J Trauma 2003;54:369-71.
8. 8. Chen EH, Logman ZM, Glass PS, Bilfinger TV. A case of tracheal injury after emergent endotracheal intubation: a review of the literature and causalities. Anesth Analg 2001;93:1270-1.

9. 9. Freiberger J. An unusual presentation of an airway tear. Anaesthesiology 1984;61:204-6.
10. 10. Gaukroger P, Anderson G. Tracheal rupture in an intubated critically ill patient. Anaesth Intensive Care 1986;14:199-201.
11. 11. Stark P. Imaging of tracheobronchial injuries. J Thorac Imaging 1995;10:206-19.
12. 12. Ramos Izquierdo R, Moya Amoros J, Morera Abad R, Pujol Rovira R, Perna V, Ferrer Recuero G. Iatrogenic tracheal rupture after endotracheal intubation. Cir Esp 2006;80:46-8.
13. 13. P. Carbognani, A. Bobbio, L. Cattelani, E. Internullo, D. Caporale, et al. Management of Postintubation Membranous Tracheal Rupture. Ann Thorac Surg 2004;77(2):406-9.
14. 14. Rossbach MM, Johnson SB, Gomez MA, Sako EY, et al. Management of Major Tracheobronchial Injuries: A 28-Year Experience. Ann Thorac Surg 1998;65(1):182-6
15. 15. Gomez-Caro Andres A, Moradiellos Diez FJ, Ausin Herrero P, et al. Successful conservative management in iatrogenic tracheobronchial injury. Ann Thorac Surg 2005;79:1872-8.
16. 16. Madden B, Datta S, Hussain I, McAnulty G. Tracheal stenting for rupture of the posterior wall of the trachea following percutaneous tracheostomy. Monaldi Arch Chest Dis 2001;56:320-1.
17. 17. Shimizu J, Hirano Y, Ishida Y, Kinoshita T, Tatsuzawa Y, Kawaura Y. Use of a silicone T-tube for management of a tracheal injury in a patient with cervical blunt trauma. Jpn J Thorac Cardiovasc Surg 2003;51:541-4.
18. 18. Wurtz A, Benhamed L, Hysi I, Conti M. Endoscopic or Conservative Management of Postintubation Tracheal Membrane Laceration. Ann Thorac Surg 2011;91(5):1654-5.
19. 19. Sierra DH. Fibrin Sealent Adhesive Systems: A Review of Their Chemistry, Materiel Properties and Clinical Applications. Journal of Biomaterials Application 1993;7(4):309-52.
20. 20. Aydemir B, Celik S, Uncu O, Tanrıkulu H, Okay T. Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases. Open Journal of Thoracic Surgery 2013;3:130-4
21. 21. Ishibashi H, Ohta S, Hirose M, Akimoto T. Blunt Tracheal Transection and Long Tear in Posterior Membranous Trachea. Eur J Cardiothorac Surg 2006;30(6):945-7.
22. 22. Borasio P, Ardissone F, Chiampo G. Post-Intubation Tracheal Rupture. A Report of Ten Cases. Eur J Cardiothorac Surg 1997;12(1): 98-100.