[Iatrogenic postintubation tracheal rupture]

Iatrogenic damage to the trachea in its intubation and during artificial lung ventilation ,is a rare, severe and commonly fatal complication in resuscitative care. The risk for tracheal damage increases in emergency, time shortage and hypoxia in a patient, while intubating with a double-lumen tube, using rigid mandrin guides without a safety limit stop, and having difficulties in intubating the patient due to his/her anatomic features. Fibrotracheoscopy is the principal diagnostic techniques that may cause tracheal rupture, which may be transformed to a therapeutic measure, by placing an intubation tube caudally at the site of tracheal rupture. Among 33 patients, only 6 underwent surgical defect suturing. When the trachea is ruptured, surgery is indicated for respiratory hemorrhage unstopped by inflating the cuff of an intubation tube and, perhaps, associated with the damage to a large vessel; for progressive gas syndrome, extensive rupture of the membranous part with the involvement of the tracheal bifurcation and main bronchus or with the interposition of paratracheal tissues; for a concomitant damage to the esophagus; for rupture of the tracheal membranous part during intubation before thoracotomy or for rupture detected during thoracotomy for another cause. Correct and timely care may eliminate this life-threatening iatrogenic complication, by yielding a good effect.