Successful rescue using tracheal intubation cannula for severe central airway stenosis after tracheotomy: A CARE compliant case report

• Published in: Medicine (Baltimore) Vol. 99; no. 21; p. e20117
• Main Authors: Li, Hai-Feng, Xing, Bao-Peng, Song, Li-Sha, Wang, Wei, Liu, Bao-Hua
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 22.05.2020
• Subjects: Aged; Airway Obstruction - therapy; Clinical Case Report; Humans; Intubation, Intratracheal - methods; Male; Tracheal Stenosis - therapy; Tracheotomy - adverse effects
• DOI: 10.1097/MD.0000000000020117
• ISSN: 0025-7974

Central airway stenosis is a life-threating requiring immediate medical intervention. There are several options for treating central airway stenosis, including rigid bronchoscopy, bronchoscopic high-power laser therapy, high-frequency electric needle knife, and balloon-expanding stents. However, interventional techniques may be unavailable in an emergent situation or at smaller local hospitals. In this case report, we publicly demonstrate for the first time that a tracheal intubation catheter may be applied as a temporary alternative to interventional bronchoscopic treatment. A 72-year old male patient was admitted with a 1-year history of intermittent dyspnea, which was exacerbated for one day. One day prior to admission to our hospital, the patient presented with cyanosis due to an exacerbation of dyspnea.A tracheotomy was performed and the patient had been carrying a tracheotomy cannula for 6 months. The ventilator alarm indicated high airway resistance and the nurses were unable to insert the suction pipes into the airway. Immediate fiberoptic bronchoscopy showed diffuse edema and stenosis of the inferior tracheal airways. Tracheal intubation was used to temporarily replace the tracheotomy cannula, which successfully expanded the narrowed airways. The blood oxygen saturation returned to normal, and dyspnea was quickly relieved. In emergent situations, tracheal intubation catheters may be used in patients with post-tracheotomy central airway stenosis, not only for surviving the most dangerous phase but for also prolonging the survival time for further treatments.