Airway Management During Unusual Tracheal Stenosis

Istanbul University24 enrolled

Overview

Tracheal stenosis is a serious complication following prolonged intubation. There are important differences in the challenges of airway management. This study consists of our anesthesia management experience in patients with unusual placement of tracheal stenosis due to Covid-19 undergoing tracheal dilatation.

Tracheal stenosis is a serious complication following prolonged intubation. Two types of tracheal stenosis; Glottic and subglottic stenoses have common features in that they are challenging in terms of ventilation, oxygenation and intubation. However, there are important differences in the challenges of airway managementA thinner tube may be sufficient to overcome the airway difficulty in glottic stenoses. However, in subglottic tracheal stenosis, a thinner tube may not be conveyed to the distal of the stenosis. As a result, adequate ventilation and oxygenation may not be provided with an intubation tube placed proximal to the trachea. This study consists of our anesthesia management experience in patients with unusual placement of tracheal stenosis due to Covid-19 undergoing tracheal dilatation.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Tracheal Stenosis

Interventions

Flow Controlled VentilationOTHER

Anesthesia management in patients with subglottic tracheal stenosis with flow-controlled ventilation using an intubation tube with an inner diameter of less than 3 mm

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * ASA 1-2-3 patients over the age of 18 who are scheduled for an elective laryngeal procedure due to subglottic stenosis will be included in our study. Exclusion Criteria: 1. Patients who did not agree to participate in the study. 2. Congestive heart failure (ejection fraction ≤ 35 %) 3. Emergency laryngeal procedures. 4. Patients under 18 years old. 5. Patients with ASA \> 3.

Locations (1)

Istanbul University, Department of Anesthesiology

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

PCO2

blood partial pressure of carbondioxide

Time frame: PCO2 value at baseline just before entubation, peroperative 5, 15, 30, 45 minutes after induction, and before the extubation through surgery completion

PO2

blood partial pressure of oxygen

Time frame: PO2 value at baseline just before entubation, peroperative 5, 15, 30, 45 minutes after induction, and before the extubation through surgery completion

Secondary Outcomes

EtCO2

end-tidal carbondioxide measurement

Time frame: EtCO2 value at baseline just before entubation, peroperative 5, 15, 30, 45 minutes after induction, and before the extubation through surgery completion

length of intubation due to Covid-19 Pnomonia

time from intubation to extubation in ICU

Time frame: postoperative period (up to 1 year)

sPO2

peripheral oxygen saturation

Time frame: SPO2 value at baseline, peroperative 5, 15, 30, 45 minutes after induction, and before the extubation through surgery completion

Myers-Cotton grading scale (1/2/3)

The grade of tracheal stenosis

Time frame: before the surgery

VAS (Visual Analogue Scale) score (between 0 to 10 points)

surgeons' satisfaction(VAS 0=the worst view, 10= the best view)

Time frame: during surgery through surgery completion

Data from ClinicalTrials.gov

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