[Postintubation tracheal stenosis]

Area of Science:

• Medical Sciences
• Pulmonology
• Critical Care Medicine

Background:

• Postintubation tracheal stenosis (PITS) is an increasing iatrogenic complication.
• Its incidence rises with expanded intensive care unit (ICU) use and endotracheal intubation indications.
• PITS presents a spectrum of severity, from asymptomatic to critical airway obstruction.

Purpose of the Study:

• To highlight the diagnostic and therapeutic considerations for PITS.
• To emphasize the importance of considering PITS in patients with a history of intubation and dyspnea.
• To review treatment options, including surgical and bronchoscopic interventions.

Main Methods:

• Diagnosis relies on fiberoptic/rigid bronchoscopy, considered the gold standard.
• Evaluation of clinical presentation and patient candidacy for surgical intervention.
• Review of treatment outcomes for both tracheal resection and end-to-end anastomosis (TRA) and bronchoscopic methods.

Main Results:

• PITS requires consideration in patients with difficult breathing post-intubation.
• Fiberoptic/rigid bronchoscopy is the definitive diagnostic tool.
• Tracheal resection and end-to-end anastomosis (TRA) is the preferred surgical treatment.
• Bronchoscopic interventions are vital for non-surgical candidates or as a bridge to surgery.

Conclusions:

• PITS is a significant complication requiring high clinical suspicion.
• Bronchoscopy is essential for accurate diagnosis.
• While TRA is preferred, bronchoscopic interventions provide crucial therapeutic alternatives, potentially being curative in select cases.