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Management of blunt tracheobronchial trauma in the pediatric age group

Q Ballouhey1, R Fesseau2, V Benouaich3

  • 1Department of Pediatric Surgery, Children's Hospital, 330 Avenue de Grande-Bretagne TSA 70034, 31059, Toulouse Cedex 9, France. q.ballouhey@gmail.com.

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
|January 28, 2016
PubMed

Insights

Pediatric tracheobronchial rupture (TBR) requires prompt diagnosis and management. Bronchoscopy, surgery, and extracorporeal membrane oxygenation (ECMO) can optimize emergency care for severe blunt chest trauma cases.

Area of Science:

  • Pediatric Trauma Surgery
  • Thoracic Surgery
  • Emergency Medicine

Background:

  • Tracheobronchial rupture (TBR) is a rare, life-threatening injury in children following blunt chest trauma.
  • Effective emergency management strategies are crucial for improving outcomes.

Purpose of the Study:

  • To propose an optimized treatment strategy for pediatric tracheobronchial rupture.
  • To evaluate the role of bronchoscopy, surgery, and ECMO in managing these injuries.

Main Methods:

  • Retrospective review of 27 pediatric patients with post-traumatic TBR treated since 1996.
  • Analysis of diagnostic and therapeutic interventions, including flexible bronchoscopy, operative repair, and ECMO.

Main Results:

  • Flexible bronchoscopy aided in visualizing rupture extent and endotracheal tube placement.
  • Five patients underwent operative repair; four had life-threatening conditions requiring ECMO support.
  • ECMO provided crucial ventilatory support for severe respiratory distress and hemodynamic instability.

Conclusions:

  • Prompt diagnosis and management are essential for pediatric TBR patients.
  • Bronchoscopy is a critical diagnostic tool.
  • Surgery is indicated for large tears, with ECMO as a potentially beneficial supportive therapy in select critical cases.
Abstract

Keywords:
BronchoscopyChildrenECMOTracheobronchial trauma

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