Selective fiberoptic left main-stem intubation to treat bronchial laceration in an extremely low birth weight neonate

Dorn, Charlotte S. Van; Sittig, Steven E.; Koch, Cody A.; Thompson, Dana M.; Carey, William A.

doi:10.1016/j.ijporl.2010.03.022

Cited by 9 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their proposed treatment included broad-spectrum antibiotics and anti-inflammatory aerosols [ 9 , 10 ], while our patient received a course of broad-spectrum antibiotics and steroids (intravenous dexamethasone). Small tears requiring intubation could be managed with a cuff being placed distal to the site of the injury or selective bronchial intubation [ 3 , 6 , 11 ]. The use of extracorporeal membrane oxygenation was also reported as a means to provide cardiorespiratory support in paediatric patients who sustained blunt trauma to the chest [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

Paediatric Longitudinal Tracheal Laceration From Blunt Force Trauma: A Case Report

Loroch¹,

Curran²,

Wynne³

2021

Cureus

View full text Add to dashboard Cite

Tracheal lacerations in the paediatric population are not common; however, they can be life-threatening. Prompt diagnosis and management are essential for a good prognosis. Here, we present the case of a nine-year-old boy who presented to the hospital following a bicycle handlebar injury with neck pain and subcutaneous emphysema of the anterior thorax and neck. Chest X-ray revealed pneumomediastinum and a small pneumothorax. A computed tomography scan revealed a posterior longitudinal laceration of the trachea, measuring 1.5 cm, located superior to the carina at T1/2. As the patient was clinically stable, did not require any supplemental oxygen, and the tear was smaller than 2 cm, conservative management with steroids and broad-spectrum antibiotics was implemented. The patient was transferred to a tertiary ENT centre in Glasgow for observation in the paediatric intensive care unit where he recovered uneventfully. A repeat cross-sectional imaging six days after the injury revealed successful healing of the laceration. Non-surgical management of a tracheobronchial injury can be an effective approach. This can be considered in the case of tears measuring <2 cm and in clinically stable patients. Imaging-based diagnosis in the case of patients with minor injuries who are improving with conservative treatment may be sufficient, and confirmation with bronchoscopy would be of questionable clinical value in such patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Paediatric Longitudinal Tracheal Laceration From Blunt Force Trauma: A Case Report

Loroch¹,

Curran²,

Wynne³

2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Flexible bronchoscope allows direct visualization of the airway and prompt diagnosis of anatomic abnormalities that may preclude advancement of the ETT into the left main bronchus. 10 Even though we used flexible bronchoscopy to verify our ETT position after left mainstem intubation, we achieved our goal much more efficiently and with less interference with ventilation by not initially relying on bronchoscopy. We also needed to have a technique that would allow us to efficiently intubate the left mainstem should dislodgement of the ETT into the trachea occur, given the low margin of error.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have described the use of rigid 1 or flexible 2 , 10 bronchoscopy or a stylet 3 to guide left bronchial intubation. Flexible bronchoscope allows direct visualization of the airway and prompt diagnosis of anatomic abnormalities that may preclude advancement of the ETT into the left main bronchus.…”

Section: Discussionmentioning

confidence: 99%

Selective left mainstem bronchial intubation in the neonatal intensive care unit

Flavin

Fleming

et al. 2018

Brazilian Journal of Anesthesiology (English Edition)

View full text Add to dashboard Cite

“…Immediate surgical repair remains warranted in those patients whose tear is large and in those who require mechanical ventilation that cannot be delivered past the distal laceration [8,9] . In the subgroup of pediatric patients subjected to this kind of injury, the operation is more difficult, and the majority were treated conservatively [3,4,10] . The ECMO technology offers significant support for the conservative option.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Life Threatening Tracheal Tear in Pediatric Patient; A Challenging Case to Manage

Barák¹

2015

JAS

View full text Add to dashboard Cite

We present a case in which an 11 month old baby with Johanson-Blizzard Syndrome developed respiratory failure due to respiratory syncytial virus. The baby was intubated and re-intubated several times using different endotracheal tube sizes in an effort to improve ventilation. While in the pediatric intensive care unit, her condition deteriorated and a tear at the posterior wall of the trachea adjacent to the carina was diagnosed. An attempt to correct surgically the tear failed. During that surgery hypoxemia occurred followed by cardiac arrest. The resuscitation that was carried out was successful and the child recovered in the pediatric intensive care unit for several days without additional surgical intervention. We discuss the management of a tracheal tear in the pediatric population, particularly the conservative as opposed to the surgical approach.

show abstract

Selective fiberoptic left main-stem intubation to treat bronchial laceration in an extremely low birth weight neonate

Cited by 9 publications

References 13 publications

Paediatric Longitudinal Tracheal Laceration From Blunt Force Trauma: A Case Report

Paediatric Longitudinal Tracheal Laceration From Blunt Force Trauma: A Case Report

Selective left mainstem bronchial intubation in the neonatal intensive care unit

Iatrogenic Life Threatening Tracheal Tear in Pediatric Patient; A Challenging Case to Manage

Contact Info

Product

Resources

About