TY - JOUR
TI - COVID-19 Patients Presenting with Post-Intubation Upper Airway Complications: A Parallel Epidemic?
AU - Stratakos, G.
AU - Anagnostopoulos, N.
AU - Alsaggaf, R.
AU - Koukaki, E.
AU - Bakiri, K.
AU - Emmanouil, P.
AU - Zisis, C.
AU - Vachlas, K.
AU - Vourlakou, C.
AU - Koutsoukou, A.
JO - Journal of Clinical Medicine Research
PY - 2022
VL - 11
TODO - 6
SP - null
PB - MDPI
SN - 1918-3003, 1918-3011
TODO - 10.3390/jcm11061719
TODO - null
TODO - 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.
ER -