Life threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy in multi-trauma patient with cervical spine injury

Bartolek, Dubravka and Somun, Nenad and Bartolek, Franjo and Zdravčević-Šakić, Kata and Lajtman, Zoran and Banić, Tihomir and Cavrić, Gordana and Kovačić-Vicić, Vesna (2009) Life threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy in multi-trauma patient with cervical spine injury. Collegium Antropologicum, 33 (4). pp. 1409-13. ISSN 0350-6134

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Abstract

Percutaneous tracheostomy (PCT) is a safe method under proper patient selection, increased technical experience and bronchoscopy- or ultrasound-guided procedure. Trauma patients with cervical spine fractures and spinal cord injury are at a high risk for respiratory failure and require a definitive airway followed by prolonged mechanical ventilation. We would like to present multiple, life- threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy (GWDF) in one trauma patient with a cervical spine injury. With this case report we would like to lay emphasis on the importance of continuously bronchoscopy- or ultrasound-guided PTC in trauma patients, especially with cervical spine injury, as the need to respect the steep-learning curve in its performance.

Abstract in Croatian

ŽIVOTNO UGROŽAVAJUĆE KOMPLIKACIJE NAKON NEUSPJELA POKUŠAJA PERKUTANE TRAHEOTOMIJE KOD POLITRAUMATIZIRANOG BOLESNIKA SA OZLJEDOM VRATNE KRALJEŽNICE ----- Perkutana traheotomija (PTC) je klinički široko prihvaćena metoda osiguravanja dišnog puta u jedinicama intenzivne skrbi. Pravilna selekcija bolesnika prema opće prihvaćenim indikacijama i anatomskim markacijama uz kontinuiranu vizualizaciju postupka bronhoskopom (ili ultrazvukom) osigurava sigurno izvo|enje svakog njegovog segmenta. Sveukupni porast tehničkoga iskustva u izvo|enju PCT neminovno doprinosi smanjenju nastanka mogućih neželjenih komplikacija. Bolesnici sa ozljedom vratne kralježnice, sa ili bez pridružene ozljede vratnoga dijela le|ne moždine čine visokorizičnu skupinu bolesnika sa pojavom produžene respiracijske insuficijencije i potrebom za mehaničkom ventilacijom kod kojih je traheotomija u većini slučajeva neizbježna. Ovim opisom kliničkog slučaja želimo prikazati nastale višestuke, po život opasne komplikacije nakon neuspješnoga pokušaja izvo|enja PCT kod politraumatiziranog bolesnika sa pridruženom povredom vratnog dijela kralježnice. Njime tako|er želimo istaći važnost kontinuirane vizualizacije cjelokupnog postupka izvo|enja PTC (bronhoskopom ili ultrazvukom) kao i poštivanja graduacije stjecanja tehničke i praktične vještine osobe kao i tima koje je izvodi.

Item Type: Article
MeSH: Aged ; Bronchoscopy ; Cervical Vertebrae/injuries ; Esophageal Perforation/etiology ; Humans ; Male ; Mediastinal Emphysema/etiology ; Multiple Trauma/therapy ; Pneumothorax/etiology ; Spinal Fractures/therapy ; Surgical Procedures, Minimally Invasive ; Trachea/injuries ; Tracheostomy/adverse effects ; Tracheostomy/instrumentation
Departments: Katedra za anesteziologiju i reanimatologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Bartolek, DubravkaUNSPECIFIED
Somun, NenadUNSPECIFIED
Bartolek, FranjoUNSPECIFIED
Zdravčević-Šakić, KataUNSPECIFIED
Lajtman, ZoranUNSPECIFIED
Banić, TihomirUNSPECIFIED
Cavrić, GordanaUNSPECIFIED
Kovačić-Vicić, VesnaUNSPECIFIED
Date: December 2009
Date Deposited: 13 May 2010
Last Modified: 23 Sep 2011 16:11
Subjects: /
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/759

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