Airway obstruction and ventilator dependency in young children with congenital cardiac defects: a role for self-expanding metal stents

Intensive Care Medicine
Pankaj KumarPeter Goldstraw

Abstract

Young children with congenital cardiac defect and airway obstruction leading to ventilator dependency present a significant clinical challenge with uncertain outcome. Retrospective review of our experience with self-expanding metal stents in these young children between 1996-2000. Airway stenting has been undertaken in five such children (four boys, one girl) at our institution. Their mean age was 7.4 months (range 2-14 months), and four of the five had undergone congenital cardiac surgery and could not be weaned from the ventilator following surgery. These five children were ventilator dependent for a mean of 112 days (range 40-210 days, median 71). A total of ten self-expanding metal stents were inserted (4-11 mm in diameter and 15-33 mm in length). The sites stented included the trachea (two stents), the left main bronchus (three stents) and the bronchus intermedius (five stents). Four of these five children were successfully weaned from the ventilator and extubated after a mean time interval of 6 days (range 2-11 days, median 5.5) after stenting. One child failed to wean from the ventilator, required tracheostomy and is ventilator dependent after 8 months. There was one death 2 months after extubation but unrelated to the a...Continue Reading

Citations

Jun 9, 2006·Pediatric Radiology·Clare A McLarenDerek J Roebuck
May 9, 2003·The Annals of Thoracic Surgery·Pankaj KumarPeter Goldstraw
Oct 28, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Jay B Brodsky
Feb 19, 2013·Journal of Pediatric Surgery·Kosaku MaedaKatsuhisa Baba
Jun 3, 2008·Paediatric Respiratory Reviews·Clare A McLarenDerek J Roebuck
Feb 21, 2008·Pediatric Pulmonology·T Nicolai
Dec 21, 2004·European Journal of Radiology·Clare A McLarenDerek J Roebuck
Oct 11, 2005·The Journal of Thoracic and Cardiovascular Surgery·Aparna HoskoteLara Shekerdemian
Jul 7, 2005·The Journal of Thoracic and Cardiovascular Surgery·Itzhak VinogradAviel Silbiger
Oct 6, 2006·Current Opinion in Anaesthesiology·Jay B Brodsky

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