Open AccessExtensive Tracheal Injuries: A Reasoned Multistep Approach to Guarantee Mechanical Ventilatory Support Developed During the COVID‐19 Pandemic
Author(s) -
Mattioli Francesco,
Martone Andrea,
Andreani Alessandro,
Cappiello Gaia,
Tonelli Roberto,
Clini Enrico,
Marchioni Alessandro
Publication year - 2022
Publication title -
oto open
Language(s) - English
Resource type - Journals
ISSN - 2473-974X
DOI - 10.1177/2473974x221080446
Subject(s) - medicine , covid-19 , mechanical ventilation , tracheal tube , anesthesia , ventilation (architecture) , pandemic , respiratory failure , respiratory system , tracheal intubation , surgery , intensive care medicine , intubation , disease , virology , mechanical engineering , outbreak , infectious disease (medical specialty) , engineering
The COVID‐19 pandemic has notably increased the need for prolonged mechanical ventilation (MV) in patients with respiratory failure. This has increased the risk of extensive tracheal injury (ETI) associated with life‐threatening complications in complex cases. Furthermore, tracheal injury treatment in patients with COVID‐19 has not been described yet. Three patients with COVID‐19 and ETI who required MV between April and November 2020 were included. A multistep approach was performed to restore tracheal integrity with a custom‐remodeled stent and tracheostomy tube placement to allow ventilatory support. Efficient MV with no residual air leaks was obtained in all cases. One patient died 6 weeks after the procedure due to COVID‐19 lung damage. Two patients have completely been weaned from MV. This multistep procedure could be used to maintain ventilatory support in the case of ETI, working as a bridge to subsequent surgery when clinical conditions improve.