دورية أكاديمية
Pre-tracheotomy for Potentially Emergent Airway Scenarios: Indications and Outcomes.
| العنوان: | Pre-tracheotomy for Potentially Emergent Airway Scenarios: Indications and Outcomes. |
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| المؤلفون: | Knewitz A; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A., Nanda N; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A., Hoffman MR; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.; Department of Otolaryngology - Head and Neck Surgery, University of Alabama, Birmingham, Alabama, U.S.A., Dailey SH; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A., Wieland AM; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A., McCulloch TM; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A. |
| المصدر: | The Laryngoscope [Laryngoscope] 2021 Nov; Vol. 131 (11), pp. E2802-E2809. Date of Electronic Publication: 2021 May 22. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8607378 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-4995 (Electronic) Linking ISSN: 0023852X NLM ISO Abbreviation: Laryngoscope Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell Original Publication: St. Louis, Mo. : [s.n., 1896- |
| مواضيع طبية MeSH: | Conversion to Open Surgery/*adverse effects , Trachea/*surgery , Tracheostomy/*adverse effects , Tracheotomy/*adverse effects , Wound Closure Techniques/*adverse effects, Adult ; Aged ; Aged, 80 and over ; Airway Extubation/adverse effects ; Airway Extubation/statistics & numerical data ; Cervicoplasty/adverse effects ; Conversion to Open Surgery/statistics & numerical data ; Female ; Hemorrhage/complications ; Hemorrhage/diagnosis ; Hemorrhage/surgery ; Humans ; Laryngeal Edema/complications ; Laryngeal Edema/diagnosis ; Laryngeal Edema/surgery ; Laryngeal Neoplasms/diagnosis ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/surgery ; Laryngostenosis/complications ; Laryngostenosis/epidemiology ; Laryngostenosis/surgery ; Male ; Middle Aged ; Oropharynx/pathology ; Oropharynx/surgery ; Postoperative Complications/epidemiology ; Preoperative Care ; Retrospective Studies ; Risk Assessment ; Surgical Wound ; Thyroid Neoplasms/complications ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/surgery ; Wound Closure Techniques/statistics & numerical data |
| مستخلص: | Objectives/hypothesis: Airway access in the setting of unsuccessful ventilation and intubation typically involves emergent cricothyrotomy or tracheotomy, procedures with associated significant risk. The potential for such emergent scenarios can often be predicted based on patient and disease factors. Planned tracheotomy can be performed in these cases but is not without its own risks. We previously described a technique of pre-tracheotomy or exposing the tracheal framework without entering the trachea, as an alternative to planned tracheostomy in such cases. In this way, a tracheotomy can be easily completed if needed, or the wound can be closed if it is not needed. This procedure has since been used in an array of indications. We describe the clinical situations where pre-tracheotomy was performed as well as subsequent patient outcomes. Methods: Retrospective series of patients undergoing a pre-tracheotomy from 2015 to 2020. Records were reviewed for patient characteristics, indication, whether the procedure was converted to tracheotomy or closed at the bedside, and any post-procedural complications. Results: Pre-tracheotomy was performed in 18 patients. Indications included failed extubation after head and neck reconstruction, subglottic stenosis, laryngeal masses, laryngeal edema, thyroid masses, and an oropharyngeal bleed requiring operative intervention. Tracheotomy was avoided in 10 patients with wound closed at the bedside; procedure was converted to tracheotomy in the remaining eight. There were no complications. Indications for conversion included failed extubation, intraoperative hemorrhage, significant stridor with dyspnea, and inability to ventilate. Conclusion: Pre-tracheotomy offers simplified airway access and provides a valuable option in scenarios where tracheotomy may, but not necessarily, be needed. Level of Evidence: 4 Laryngoscope, 131:E2802-E2809, 2021. (© 2021 The American Laryngological, Rhinological and Otological Society, Inc.) |
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| فهرسة مساهمة: | Keywords: Pre-tracheotomy; airway emergency; cricothyrotomy; tracheotomy |
| تواريخ الأحداث: | Date Created: 20210522 Date Completed: 20211122 Latest Revision: 20211122 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1002/lary.29612 |
| PMID: | 34021601 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1531-4995 |
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| DOI: | 10.1002/lary.29612 |