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Journal of Zhejiang University SCIENCE B 2007 Vol.8 No.7 P.522-525

http://doi.org/10.1631/jzus.2007.B0522


Anesthetic management of emergent critical tracheal stenosis


Author(s):  ZHOU Yang-feng, ZHU Shao-jun, ZHU Sheng-mei, AN Xiao-xia

Affiliation(s):  Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   anxx6830@yahoo.com.cn

Key Words:  Tracheal stenosis, Extracorporeal circulation, Anesthesia


ZHOU Yang-feng, ZHU Shao-jun, ZHU Sheng-mei, AN Xiao-xia. Anesthetic management of emergent critical tracheal stenosis[J]. Journal of Zhejiang University Science B, 2007, 8(7): 522-525.

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author="ZHOU Yang-feng, ZHU Shao-jun, ZHU Sheng-mei, AN Xiao-xia",
journal="Journal of Zhejiang University Science B",
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pages="522-525",
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publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2007.B0522"
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%T Anesthetic management of emergent critical tracheal stenosis
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%A ZHU Shao-jun
%A ZHU Sheng-mei
%A AN Xiao-xia
%J Journal of Zhejiang University SCIENCE B
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%DOI 10.1631/jzus.2007.B0522

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T1 - Anesthetic management of emergent critical tracheal stenosis
A1 - ZHOU Yang-feng
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A1 - ZHU Sheng-mei
A1 - AN Xiao-xia
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VL - 8
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SP - 522
EP - 525
%@ 1673-1581
Y1 - 2007
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2007.B0522


Abstract: 
Two case reports of emergent anesthesia of critical tracheal stenosis are presented. The use of extracorporeal circulation may be a lifesaving method for these patients. Two patients both with severe lower tracheal stenosis were admitted with severe inspiratory dyspnea. The first patient had a tracheal tube inserted above the stenosis in the operating room, but ventilation was unsatisfactory, high airway pressure and severe hypercarbia developed, therefore extracorporeal circulation was immediately initiated. For the second patient, we established femoral-femoral cardiopulmonary bypass prior to induction of anaesthesia, and intubated above the tracheal tumor orally under general anesthesia, then adjusted the endotracheal tube to appropriate depth after the tumor had been resected. The patient was gradually weaned from cardiopulmonary bypass. The two patients all recovered very well after surgery. Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. extracorporeal circulation by the femoral artery and femoral vein cannulation can gain good gas exchange even if the trachea is totally obstructed. Therefore, before the induction of anesthesia, we should assess the site and degree of obstruction carefully and set up cardiopulmonary bypass to avoid exposing the patient to unexpected risks and the anesthesiologist to unexpected challenges.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

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