@article{3219918,
    title = "COVID-19 Patients Presenting with Post-Intubation Upper Airway Complications: A Parallel Epidemic?",
    author = "Stratakos, G. and Anagnostopoulos, N. and Alsaggaf, R. and Koukaki, E. and Bakiri, K. and Emmanouil, P. and Zisis, C. and Vachlas, K. and Vourlakou, C. and Koutsoukou, A.",
    journal = "Journal of Clinical Medicine Research",
    year = "2022",
    volume = "11",
    number = "6",
    publisher = "MDPI",
    issn = "1918-3003, 1918-3011",
    doi = "10.3390/jcm11061719",
    abstract = "During the current pandemic, we witnessed a rise of post-intubation tracheal stenosis (PITS) in patients intubated due to COVID-19. We prospectively analyzed data from patients referred to our institution during the last 18 months for severe symptomatic post-intubation upper airway complications. Interdisciplinary bronchoscopic and/or surgical management was offered. Twentythree patients with PITS and/or tracheoesophageal fistulae were included. They had undergone 31.85 (±22.7) days of ICU hospitalization and 17.35 (±7.4) days of intubation. Tracheal stenoses were mostly complex, located in the subglottic or mid-tracheal area. A total of 83% of patients had fracture and distortion of the tracheal wall. Fifteen patients were initially treated with rigid bronchoscopic modalities and/or stent placement and eight patients with tracheal resection-anastomosis. Post-treatment relapse in two of the bronchoscopically treated patients required surgery, while two of the surgically treated patients required rigid bronchoscopy and stent placement. Transient, nonlife-threatening post-treatment complications developed in 60% of patients and were all managed successfully. The histopathology of the resected tracheal specimens didn’t reveal specific alterations in comparison to pre-COVID-era PITS cases. Prolonged intubation, pronation maneuvers, oversized tubes or cuffs, and patient-or disease-specific factors may be pathogenically implicated. An increase of post-COVID PITS is anticipated. Careful prevention, early detection and effective management of these iatrogenic complications are warranted. © 2022 by the authors. Licensee MDPI, Basel, Switzerland."
}