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Overinflated Cuff Causes Tracheal Stenosis in Inhalation Injury Patient: A Case Report
燒傷病患接受氣管內插管因氣囊過度充氣產生氣管狹窄之病例報告
並列摘要
The endotracheal tube with high volume low pressure cuff is always recommended for burned patients because of a lower incidence of severe mucosal damage. A 36 year-old male was intubated for inhalation injury. Shortness of breath and stridor gradually developed after extubation, which required emergent reintubation. Subglottic stenosis was diagnosed. Circumferential tracheal resection with end-to-end anastomosis was performed. By reviewing the previous chest x-ray, an overinflated cuff was observed that might be responsible for this complication. A high cuff pressure of the endotracheal tube may cause mucosal ischemia leading to necrosis, infection, tracheomalacia, or tracheal stenosis. The subglottic stenosis may be resulted from a combination of a direct thermal injury and mechanical trauma by the tube cuff with local infection. The late symptomatic presentation of the tracheal stenosis and the causative options are discussed.
延伸閱讀
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