AI Article Synopsis
- Unexpected tracheal narrowing was discovered in a Duchenne muscular dystrophy patient during scoliosis surgery, leading to increased airway pressure and CO2 levels as the procedure continued.
- Using fiberoptic bronchoscopy, a floppy segment of the trachea was identified, and a wire-reinforced tube was positioned beyond the narrowing, correcting ventilation issues.
- In a subsequent similar case, pre-positioning fiberoptic bronchoscopy revealed another tracheal narrowing, but with proper tube placement before the patient became prone, the surgery was successfully completed without complications.
Article Abstract
Unexpected tracheal narrowing was observed in a patient with Duchenne muscular dystrophy during a corrective operation for thoracolumbar scoliosis. As the operating time progressed, peak airway pressure and end-tidal CO2 increased gradually in the prone position. We found a floppy portion of the trachea using fiberoptic bronchoscopy (FB) in the prone position. We advanced a wire-reinforced tube toward the carina beyond the lesion. This allowed correction of the ventilatory abnormalities. We encountered another patient scheduled for the same operation. We performed FB in advance before the position change and observed a narrowed portion of trachea. We advanced the tracheal tube under FB beyond the pathologic portion and then moved the patient into the prone position. The operation was done successfully without any problems.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668110 | PMC |
| http://dx.doi.org/10.4097/kjae.2013.64.5.456 | DOI Listing |
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