CASE 9--2014: Supracarinal tracheal tear after atraumatic endotracheal intubation: anesthetic considerations for surgical repair

Bronchoscopic management of iatrogenic tracheal laceration using polyurethane-covered nitinol tracheal stents

Iatrogenic tracheal laceration is a known complication of emergent endotracheal intubation. Patients with tracheal laceration present a therapeutic challenge. There is no established standard treatment approach in this patient population. Interventions reported include conservative management, stent placement, or surgery. We present our experience of tracheal tears in patients with respiratory failure successfully managed with polyurethane-covered nitinol stent, including three cases of postintubation and one case of postsurgical tracheostomy tracheal injury.

Practical anesthetic considerations in patients undergoing tracheobronchial surgeries: a clinical review of current literature

Tracheobronchial surgeries require close cooperation and extensive communication between the anesthesia providers and the surgeons. Anesthetic management of tracheal and bronchial pathologies differ basically from regular upper airways management, due access to the patients airway is limited, mostly even practically impossible for the anesthesia providers. As a consequence, the surgeon overtakes responsibility for the airway access from the anesthesia provider in the variety of the cases. Preoperative recognition of a difficult airway, detailed planning and being aware of plan B and plan C are the elementary keys to success. Providers have to be aware, that preoperative airway assessment does not always correlate with the ease of oxygenation and ventilation. Therefore, various methods have been described in the literature and several authors have adopted unique ways to manage the airways in a successful manner. With the advancement of surgical techniques over the years, anesthetic management has also evolved tremendously to match the needs. The commonly encountered conditions requiring surgical interventions include post-intubation stenosis and foreign body aspiration. In this review we will discuss the most common pathologies of tracheobronchial lesions and specific anesthetic management considerations related to them.

Assessment and Management of Post-Intubation Airway Injuries

Tracheal laceration is a known complication of endotracheal intubation. This rare complication remains a diagnostic and management challenge for today's practitioners. This clinical challenge report highlights current surgical and anesthetic management strategies.

The Diagnosis and Management of Patient with Delayed Symptoms from a Tracheal Tear

Development of subcutaneous emphysema after gastrointestinal endoscopy with general anesthesia presents a diagnostic conundrum. We discuss the management of a patient who experienced significant vomiting followed by neck and facial swelling with crepitus and shortness of breath after the endoscopic retrograde cholangiopancreatography. The presence of respiratory distress usually suggests that head and neck subcutaneous emphysema is most likely associated with pneumothorax and/or pneumomediastinum. We discuss the prevention, differential diagnosis, and current management of tracheal tears including subcutaneous emphysema.