Management of blunt tracheobronchial trauma in the pediatric age group

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Quentin BallouheyP Galinier

Abstract

Tracheobronchial rupture (TBR) due to blunt chest trauma is a rare but life-threatening injury in the pediatric age group. The aim of this study was to propose a treatment strategy including bronchoscopy, surgery and extracorporeal membrane oxygenation (ECMO) to optimize the emergency management of these patients. We reviewed a series of 27 patients with post-traumatic TBR treated since 1996 in our pediatric trauma center. Seven cases had persistent and large volume air leaks. Flexible bronchoscopy was performed in cases of persistent or large volume air leaks. It permitted accurate visualization of the rupture and its extent. It allowed for a clear-cut positioning of the endotracheal tube. Five were managed operatively. Four cases were considered to be life-threatening because of the combination of severe respiratory distress with hemodynamic instability. One of them had severe tracheal laceration and died. Another one had bilateral bronchi disconnection. Based on clinical and endoscopic findings, surgical repair was performed using extracorporeal membrane oxygenation as a ventilatory support. It provided quick relief from the injury, which was previously expected to result in a fatal issue. Prompt diagnosis and accurate manag...Continue Reading

References

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Citations

May 4, 2017·Neurosurgical Focus·Alessandro De BenedictisCarlo Efisio Marras
Jul 5, 2019·American Journal of Physical Anthropology·Raquel E FleskesTheodore G Schurr
Jan 16, 2016·Histopathology·Benjamin Y TanPuay Hoon Tan
Sep 10, 2020·The Laryngoscope·Wei-Chung HsuMichael J Rutter
Nov 11, 2017·The Korean Journal of Thoracic and Cardiovascular Surgery·Jee Won SuhJin Gu Lee
Apr 25, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Daiki WadaYasuyuki Kuwagata
Sep 21, 2021·The Annals of Otology, Rhinology, and Laryngology·Alon TaylorMarlene Soma

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