Factors affecting occurrence of post intubation and post tracheostomy tracheal stenosis in intensive care units | ||
| Egyptian Journal of Ear, Nose, Throat and Allied Sciences | ||
| Article 1, Volume 21, Issue 1, March 2020, Pages 1-4 PDF (316.08 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejentas.2019.4305.1025 | ||
| Authors | ||
| Mohammed Mahmoud Roushdy1; Hala Saad Abdel-Ghaffar2; Ahmed Ezzat Mohamed Saleh* 3 | ||
| 1Department of Otorhinolaryngology, Assiut University Hospital, Egypt | ||
| 2Department of Anaesthesia and Intensive Care, Assiut University Hospital, Egypt | ||
| 3Otolaryngology department, Faculty of medicine, Assiut University Hospital, Assiut, Egypt | ||
| Abstract | ||
| Objective: Iatrogenic tracheal stenosis is a life threatening iatrogenic complication of prolonged endotracheal intubation and tracheostomy in intensive care units (ICUs). It is one of the toughest morbidities in otolaryngology. Aim of the Study: This prospective observational study was conducted to detect the factors affecting occurrence of tracheal stenosis in patients subjected to tracheostomy after endotracheal intubation in ICUs. Patients and Methods: Sixty eight patients were included in this prospective study. They were admitted to (ICUs) and were subjected to endotracheal intubation, mechanical ventilation and tracheostomy due to prolonged intubation during their stay in (ICUs). The patients were followed up after being discharged for six months to detect incidence and factors affecting occurrence of tracheal stenosis. They were followed up using flexible fiber optic tracheobronchoscopy under local anesthesia, just after weaning from mechanical ventilation three and six months later. Results: Of the studied patients, 50 patients had no tracheal stenosis until the end of follow up period (without tracheal stenosis (WTS) group) while, 18 patients had tracheal stenosis (TS group). The mean duration of mechanical ventilation in WTS group (12.1 ± 7.6 days) was statistically shorter than that of TS groups (16.6 ± 10.4 days) (P = 0.048). Tracheostomy stoma wound sepsis was recorded in 4 patients in TS group and in 2 patients in WTS group. Conclusion: The main predisposing factors for post intubation and post tracheostomy tracheal stenosis are tracheostomy stomal wound sepsis and prolonged duration of mechanical ventilation. In contrary, tracheal cartilage injury during tracheostomy, age, sex and reason for mechanical ventilation was found to have no role in occurrence of tracheal stenosis. | ||
| Keywords | ||
| Bronchoscopy; Intensive Care Units; Mechanical Ventilation; Tracheal Stenosis; tracheostomy | ||
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