Aspiration of Fractured Tracheostomy Tube in a Prone Positioned COVID-19 Patient: A Case Report and Review of the Literature
Turkish Journal of Anaesthesiology and Reanimation, cilt.51, sa.3, ss.157-169, 2023 (ESCI, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 51 Sayı: 3
- Basım Tarihi: 2023
- Doi Numarası: 10.4274/tjar.2023.221167
- Dergi Adı: Turkish Journal of Anaesthesiology and Reanimation
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
- Sayfa Sayıları: ss.157-169
- Anahtar Kelimeler: Adverse events, critical care, mechanical complications, tracheostomy tube
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
A 61-year-old male patient diagnosed with Coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) was managed with tracheostomy and intermittent prone positioning in the intensive care unit. After a sudden deterioration, examination of tracheostomy tube (TT) and X-ray of the chest revealed that he had aspirated the fractured TT. The fractured tube was removed through the tracheostomy stoma using a rigid ventilating bronchoscope and forceps. Prone positioning is a beneficial postural therapy capable of improving patient oxygenation. However, it has some complications, like unplanned extubation and facial tissue injury. Percutaneous tracheostomy is also a valuable and safe procedure and has been increasingly performed in critical care patients, including those who suffer from COVID-19 ARDS. Fractures and aspiration of a tracheostomy tube can occur anytime after tracheostomy. We think prone positioning may contribute to the rupture and aspiration of the tracheostomy tube in this study.