Postintubation cicatricial stenosis of the trachea and ways of its elimination

Abstract

Background. With prolonged mechanical ventilation, which is necessary for patients with critical conditions and prolonged surgical interventions, the risk of developing cicatricial stenosis of the trachea is high. Currently, there are no uniform standards of prevention and an algorithm for the treatment of this serious complication, which in some cases leads to disability of the patient and fatal outcomes. The purpose of this work was a brief review of the literature on the problem of post-intubation tracheal stenosis and a demonstration of a clinical case of successful radical treatment of a patient. Materials and methods. The article presents a clinical case of reconstructive surgical treatment of a patient with decompensated cicatricial tracheal stenosis (90%), detected 2 months after prolonged mechanical ventilation (ventilator). Result. During dynamic follow-up 6 months after radical surgical treatment, the patient was not diagnosed with signs of respiratory failure and recurrence of tracheal stenosis, confirmed by CT data of the chest organs and bronchoscopy. Conclusions. Patients on long-term ventilation should be prevented from tracheal stenosis. Depending on the level, extent, and degree of tracheal stenosis, a personalized treatment strategy for the patient should be chosen. With the development of decompensated stenosis, radical surgical treatment is the method of choice.

Keywords

• complications of prolonged ventilation
• cicatricial tracheal stenosis
• tracheal resection