ID | 118365 |
タイトル別表記 | extubation failure due to subglottic stenosis
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著者 |
Nakano, Yuki
Tokushima Prefectural Miyoshi Hospital
Ishitani, Emi
Tokushima University
佐藤, 功志
Tokushima University
Momota, Kazuki
Tokushima University
Bando, Natsuki
Tokushima University
秋本, 雄祐
Tokushima Prefectural Miyoshi Hospital
|
キーワード | subglottic stenosis
tracheostomy
postoperative extubation failure
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資料タイプ |
学術雑誌論文
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抄録 | Background : This report describes a case of dynamic inspiratory airway collapse concomitant with subglottic stenosis in a patient who previously underwent tracheostomy that led to repeated post-operative extubation failure. Case presentation : A 43-year-old woman who had undergone tracheostomy 25 years previously was admitted to our intensive-care unit (ICU) after coronary artery bypass graft surgery. On postoperative day (POD) 0, she was extubated, but stridor was observed. We suspected upper airway obstruction and she was therefore reintubated. Before reintubation, urgent laryngotracheoscopy revealed dynamic inspiratory airway collapse and obstruction concomitant with subglottic stenosis. Preoperative computed tomography showed mild subglottic stenosis. Although intravenous corticosteroids were administered to prevent tracheal mucosal edema and a cuff leak test was confirmed to be negative, she developed extubation failure on POD6. On POD12, we performed tracheostomy to reduce mechanical irritation from the endotracheal tube. Mechanical ventilation was withdrawn and she discharged from the ICU. On POD33, her tracheostomy tube was removed and she remained clinically asymptomatic. Conclusions : We should be aware of the history of tracheostomy, especially at high tracheostomy sites, even in the absence of respiratory symptoms as risk factors for dynamic inspiratory airway collapse concomitant with subglottic stenosis contributing to repeated respiratory failure after extubation.
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掲載誌名 |
The Journal of Medical Investigation
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ISSN | 13496867
13431420
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cat書誌ID | AA11166929
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出版者 | Tokushima University Faculty of Medicine
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巻 | 70
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号 | 1-2
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開始ページ | 301
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終了ページ | 305
|
並び順 | 301
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発行日 | 2023-02
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EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
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著者版フラグ |
出版社版
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部局 |
病院
医学系
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