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Concomitant Intubation with Minimal Cuffed Tube and Rigid Bronchoscopy for Severe Tracheo-Carinal Obstruction

Title: Concomitant Intubation with Minimal Cuffed Tube and Rigid Bronchoscopy for Severe Tracheo-Carinal Obstruction
Authors: Vannucci J.; Capozzi R.; Vinci D.; Ceccarelli S.; Potenza R.; Scarnecchia E.; Spinosa E.; Romito M.; Napolitano A. G.; Puma F.
Contributors: Vannucci, J.; Capozzi, R.; Vinci, D.; Ceccarelli, S.; Potenza, R.; Scarnecchia, E.; Spinosa, E.; Romito, M.; Napolitano, A. G.; Puma, F.
Publication Year: 2023
Collection: IRIS Università degli Studi di Perugia
Subject Terms: airway; anesthesia; intubation; rigid bronchoscopy; tracheal stenosis
Description: Background: Our aim was to report on the use of an innovative technique for airway management utilizing a small diameter, short-cuffed, long orotracheal tube for assisting operative rigid bronchoscopy in critical airway obstruction. Methods: We retrospectively reviewed the clinical data of 36 patients with life-threatening critical airway stenosis submitted for rigid bronchoscopy between January 2008 and July 2021. The supporting ventilatory tube, part of the Translaryngeal Tracheostomy KIT (Fantoni method), was utilized in tandem with the rigid bronchoscope during endoscopic airway reopening. Results: Indications for collateral intubation were either tumors of the trachea with near-total airway obstruction (13), or tumors of the main carina with total obstruction of one main bronchus and possible contralateral involvement (23). Preliminary dilation was necessary before tube placement in only 2/13 patients with tracheal-obstructing tumors (15.4%). No postoperative complications were reported. There was one case of an intraoperative cuff tear, with no further technical problems. Conclusions: In our experience, this innovative method proved to be safe, allowing for continuous airway control. It enabled anesthesia inhalation, use of neuromuscular blockage and reliable end-tidal CO2 monitoring, along with protection of the distal airway from blood flooding. The shorter time of the procedure was due to the lack of need for pauses to ventilate the patient.
Document Type: article in journal/newspaper
File Description: ELETTRONICO
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/37629301; info:eu-repo/semantics/altIdentifier/wos/WOS:001056749300001; volume:12; issue:16; firstpage:5258; journal:JOURNAL OF CLINICAL MEDICINE; https://hdl.handle.net/11391/1562033
DOI: 10.3390/jcm12165258
Availability: https://hdl.handle.net/11391/1562033; https://doi.org/10.3390/jcm12165258; https://www.mdpi.com/2077-0383/12/16/5258
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.141AEC70
Database: BASE