Martínez-de los Santos CA, León-Álvarez E, Sancho-Hernández R

Language: Spanish
References: 16
Page: 234-240
PDF size: 460.17 Kb.

ABSTRACT

Introduction: Congenital tracheal stenosis (CTE) is a serious and rare malformation due to the absence of most or all of the tracheal pars membranosa with the presence of a variable number of complete tracheal rings, which determine a fixed narrowing of the tracheal lumen; produce life-threatening respiratory failure, requires prompt diagnosis and treatment; there are few series and case reports and even fewer reports regarding anesthetic management. The objective of this clinical case is a review of the current bibliography in order to establish a protocol and recommendations for anesthetic and perioperative management.
Clinical case: 6-month-old male; with Down syndrome, congenital hypothyroidism, congenital stenosis of the middle and lower third of the trachea and left bronchus diagnosed by rigid laryngobronchoscopy, scheduled for sliding tracheobronchial plasty managed under balanced general anesthesia, fluid control and intercommunication during perioperative critical moments and near postanesthetic surveillance. Extubated 10 days later, discharge to the floor 6 days later and hospital discharge 40 days postoperatively.
Conclusions: Timely and effective treatment of CTE is challenging and requires multidisciplinary treatment. Beyond the discussion about the ideal drug and type of anesthesia, management should be based on protocols with clear objectives and goals and focus on the critical moments of the procedure, airway pressure, adequate oxygen, and strict perioperative care. It is important to consolidate the experience in the country in order to obtain better results in these patients.

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