Tracheal Stenosis After Prolonged Intubation Due to COVID-19

Area of Science:

• Pulmonology
• Critical Care Medicine
• Otolaryngology

Background:

• COVID-19 patients requiring invasive mechanical ventilation (IMV) are at risk for airway complications.
• Tracheal stenosis is a potential sequela of prolonged intubation and mechanical support.
• Understanding the characteristics and outcomes of tracheal stenosis post-COVID-19 IMV is crucial for patient management.

Purpose of the Study:

• To evaluate the characteristics of patients who developed tracheal stenosis after IMV due to COVID-19.
• To assess the management outcomes for tracheal stenosis in this patient population.
• To identify risk factors associated with tracheal stenosis following COVID-19 related IMV.

Main Methods:

• Retrospective analysis of 208 patients who underwent IMV for COVID-19.
• Flexible bronchoscopy for diagnosis and treatment evaluation of tracheal stenosis.
• Rigid bronchoscopy utilized for tracheal stenosis dilatation.
• Comparison of patients with and without tracheal stenosis.

Main Results:

• Tracheal stenosis was identified in 7 of 208 patients (3.3%).
• Patients with tracheal stenosis had a significantly longer duration of IMV (27.9 days) compared to those without (11.2 days).
• Stenoses were predominantly complex-type (57%); management included bronchoscopic dilatation (3 patients) and tracheal resection (4 patients).

Conclusions:

• Tracheal stenosis is an important complication in COVID-19 patients treated with IMV.
• Prolonged IMV support is the most significant characteristic associated with the development of tracheal stenosis.
• Early diagnosis and appropriate intervention are key to managing post-IMV tracheal stenosis.