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Post-intubation tracheal stenosis after severe COVID-19 infection: A report of two cases
Author(s) -
Ahmad Alturk,
Albaraa Bara,
Bassam Darwish
Publication year - 2021
Publication title -
annals of medicine and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.391
H-Index - 23
ISSN - 2049-0801
DOI - 10.1016/j.amsu.2021.102468
Subject(s) - medicine , intubation , stenosis , tracheal stenosis , mechanical ventilation , intensive care unit , tracheal intubation , surgery , bronchoscopy , complication , lumen (anatomy) , anesthesia , airway , intensive care medicine , radiology
and importance Coronavirus disease 2019 (COVID-19) is a pandemic disease that spread rapidly throughout the world and became a major public health concern. Approximately 5–12% of COVID-19 patients require admission to the intensive-care unit (ICU), where they often require oxygen therapy and prolonged intubation. Post-intubation laryngotracheal stenosis (PILS) is a complication that occurs in 10–22% of non-COVID-19 patients after prolonged intubation, while the rate of COVID-19 related PILS remains unknown. Additionally, there is still no consensus in the literature regarding the management modalities for PILS following COVID-19. Case presentation Here we report two cases of tracheal stenosis after prolonged intubation due to severe COVID-19 infection. The first patient was admitted to the ICU and intubated for 21 days; 3 months after discharge, he developed a 3 cm long tracheal stenosis that narrowed 70% of the lumen. The second patient was intubated for 2 months and, 4 months after discharge, developed a 2.5 cm long tracheal stenosis that narrowed 80% of the lumen. Clinical discussion In both cases, the diagnosis was confirmed by CT scan and Rigid bronchoscopy; then, they were managed successfully with tracheal resection and reconstruction by end-to-end anastomosis. Conclusion In conclusion, we would like to highlight the importance of suspecting PILS in recovered COVID-19 patients re-presenting with breathing difficulties following weaning from mechanical ventilation; therefore, careful follow-up in such patients is required. Moreover, we would like to point out that the management of tracheal stenosis after COVID-19 appears to be similar to that of tracheal stenosis in general.

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