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ISSN 1025-0255 (Electronic)

2015, Number 6

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AMC 2015; 19 (6)

Emergency tracheoplasty in low tracheal stenosis with the application of independent mechanical ventilation: presentation of two cases

García ÁPJ, García AAP, Santana ÁJ, Ravelo GO, González GI

Language: Spanish
References: 32
Page: 635-645
PDF size: 532.01 Kb.


ABSTRACT

Background: the use of artificial mechanical ventilation with endotracheal intubation has been of great help for many patients; nevertheless, it has been the cause of multiple serious complications like post-intubation low tracheal stenosis. Tracheal surgery is an anesthetic challenge due to the difficulty that the maintenance of ventilation entails. Independent pulmonary ventilation can be used in emergency situations.
Objective: to show the anesthetic conduct to follow in both cases in which this ventilation technique was needed.
Clinical cases: two cases with low tracheal stenosis that underwent emergency surgeries to conduct a circumferential resection of affected tracheal rings and an end-to-end anastomosis. The presurgical evaluation made by the anesthesiologists, result of the imaging and gasometric studies, is described. The premedication is presented, as well as the anesthetic plan created with special emphasis on the trans-operating stage in which conducting an independent asynchronous ventilation with two different equipment as a saving measure was needed. The post-operating care of the patient is described.
Conclusions: it is of vital importance that the anesthesiologist knows the exact spot of the stenosis during the pre-operating evaluation. Values of volume and pressure for the use of independent asynchronous ventilation are proposed as an irreplaceable measure in emergency situations. This measure can be used in places where there are not the best conditions to apply other ventilation methods.


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