Abstract

Introduction: Iatrogenic injury to the tracheobronchial tree during intubation is a rare but life-threatening event. Since 1995 there have been isolated case reports of the use of Extracorporeal Membrane Oxygenation Therapy (ECMO) as an adjunct in the treatment of tracheal injuries.

Objective: Here we present a literature review of the management strategies employed in iatrogenic tracheal injury and the first case series using ECMO as an adjunct in its management.

Methods: We searched MEDLINE and EMBASE databases using the Healthcare Databases Advanced Search (HDAS) through the National Institute for Health and Care Excellence (NICE). We limited our search to articles after 1995, when ECMO was first introduced as an adjunct, and to articles written in the English language. We also searched the same databases separately for articles evidencing the use of ECMO in the treatment of iatrogenic tracheal injury.

Results: More recently conservative approach has been favoured over operative intervention unless the injury is observed intraoperatively and repaired primarily. Evidence for stenting is limited and of poor quality. No studies have investigated the use of prophylactic antibiotics. Numerous prevention strategies have resulted in a reduction in the incidence of iatrogenic tracheal injury. ECMO has been utilised successfully in the last 4 years in numerous institutions.

Conclusions: We have demonstrated in our case reports and the others reviewed that ECMO can be useful in patients with ventilatory difficulty either caused by concurrent respiratory pathology, direct sequelae relating to the injury or in the immediate post-operative phase.

Keywords: Extracorporeal Membrane Oxygenation Therapy (ECMO); Iatrogenic Injury

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Citation

Citation: John Rocke., et al. “Management Strategies in Iatrogenic Tracheal Injuries: A Literature Review and Case Series". Acta Scientific Otolaryngology 2.3 (2020): 24-30.

Copyright

Copyright: © 2020 John Rocke., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.