کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6213043 1605978 2016 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Successful conservative management of a rare complication of tracheostomy; extensive posterior tracheal false pouch
ترجمه فارسی عنوان
مدیریت موفقیت محافظه کارانه از عوارض نادر تراکئوستومی؛ کیسه نادرست تراشه خلفی
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های گوش و جراحی پلاستیک صورت
چکیده انگلیسی

IntroductionWith the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it.ObjectiveWe report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant. This was managed successfully with conservative treatment.ResultsA former 34-week premature infant was transferred to our pediatrics intensive care unit (PICU) with recurrent episodes of cardiopulmonary arrests due to suspected severe tracheobronchomalacia.The patient has bronchopulomonary dysplasia, severe restrictive lung disease and thoracic insufficiency from skeletal dysplasia requiring tracheostomy tube (TT) at two-month-old and mechanical ventilation. The 3.5 NEO TT was gradually upsized to a 5. The PEEP setting at transfer was 18cmH2O.The direct laryngoscopy and bronchoscopy showed moderate tracheomalacia at the innominate artery with a false pouch in the posterior tracheal wall that was 1.1cm below the tracheostomy stoma. A multi-disciplinary discussion including otolaryngology, PICU, Pulmonary Medicine, and Pediatric Surgery decided on conservative management. The false pouch healed and she was transferred back to referring PICU after a 46-day.ConclusionTracheal wall erosion resulting in a pouch formation is a rare complication, but it should be considered in patients with long term tracheostomy with difficulty ventilation and oxygenation with positional change. DLB is a useful tool in its diagnosis and conservative management can be successful.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Pediatric Otorhinolaryngology - Volume 90, November 2016, Pages 54-57
نویسندگان
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