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Intubation injuries of the trachea in children. Management and prevention
Insights
Pediatric tracheal injuries from intubation can occur despite preventive measures. An aggressive treatment combining bronchoscopy, steroids, and stenting may prevent tracheal stenosis and allow decannulation.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Critical Care
Background:
- Intubation is a common procedure in pediatric critical care.
- Tracheal injuries can occur during intubation despite preventive measures.
- These injuries may lead to long-term complications like tracheal stenosis.
Purpose of the Study:
- To summarize the problem of tracheal injuries in children following intubation.
- To outline preventive strategies for tracheal injuries.
- To describe an aggressive treatment approach for acute intubation injuries.
Main Methods:
- Review of intubation injuries in pediatric patients.
- Implementation of preventive measures.
- Aggressive treatment protocol including bronchoscopic evaluation, intratracheal and systemic steroids, and tracheal stenting with an endotracheal tube.
Main Results:
- Fifteen children experienced acute intubation injuries despite preventive measures.
- The aggressive treatment approach was employed in these cases.
- The therapy appeared to prevent cicatricial stenosis and facilitate permanent decannulation.
Conclusions:
- Acute tracheal injuries in children post-intubation require prompt and aggressive management.
- Combined therapy of bronchoscopy, steroids, and stenting shows promise in preventing tracheal stenosis.
- This approach may improve outcomes, allowing for permanent decannulation in pediatric patients.
Abstract:
The problem of intubation injuries of the trachea in children has been summarized. Preventive measures designed to protect the trachea from injury have been outlined. In spite of these measures, acute intubation injuries have occurred in 15 children. An aggressive approach combining bronchoscopic evaluation, intratracheal injection of steroids, tracheal stenting with an endotracheal tube and systemic steroids has been employed in the treatment of these injuries. We feel that this therapy has prevented the development of cicatrical stenosis in many of the cases and has allowed permanent decannulation of the trachea.