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[Bleeding following tracheostomy: the brachiocephalic trunc]
Zentralblatt Fur Chirurgie
|January 1, 1981
Summary
Hemorrhage after tracheostomy can affect great supraaortic vessels, particularly the brachiocephalic trunc. Emergency surgery like ligation or resection is effective, with vascular reconstruction considered later.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Tracheostomy Complications
Context:
- Life-threatening hemorrhage is a known risk following tracheostomy, affecting great supraaortic vessels.
- Lesions of the brachiocephalic trunc occur in 0.6-1.1% of these cases.
Purpose:
- To outline management strategies for acute hemorrhage involving the brachiocephalic trunc after tracheostomy.
- To emphasize the role of immediate surgical intervention and the secondary consideration of vascular reconstruction.
Summary:
- Acute hemorrhage from great supraaortic vessel lesions post-tracheostomy can be managed by endotracheal tube cuff hyperinflation.
- Immediate emergency surgery, including ligation or resection of the brachiocephalic trunc, is the primary treatment.
- Cerebral damage is not anticipated following these emergency procedures.
Impact:
- Provides a clear management algorithm for a rare but severe tracheostomy complication.
- Highlights the effectiveness of prompt surgical control in preventing adverse neurological outcomes.
- Informs surgical decision-making regarding the timing of vascular reconstruction versus primary vessel ligation/resection.