Fan QM, Yang WG. Use of a modified tracheal tube in a child with traumatic bronchial rupture: A case report and review of literature. World J Clin Cases 2021; 9(29): 8915-8922 [PMID: 34734075 DOI: 10.12998/wjcc.v9.i29.8915]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2021; 9(29): 8915-8922 Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8915
Use of a modified tracheal tube in a child with traumatic bronchial rupture: A case report and review of literature
Qi-Meng Fan, Wei-Guo Yang
Qi-Meng Fan, Wei-Guo Yang, Pediatric Intensive Care Unit, Shenzhen Children's Hospital, Shenzhen 518000, Guangdong Province, China
Qi-Meng Fan, Medical College, Shantou University, Shantou 515063, Guangdong Province, China
Author contributions: Fan QM collected data, reviewed the literature and drafted the manuscript; Yang WG contributed to diagnosis, treatment, and revision of the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the guardian of the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CASE Checklist (2016), and the manuscript was prepared and revised according to the CASE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Received: June 19, 2021 Peer-review started: June 19, 2021 First decision: July 5, 2021 Revised: July 17, 2021 Accepted: August 6, 2021 Article in press: August 6, 2021 Published online: October 16, 2021
Abstract
BACKGROUND
Trauma is one of the leading causes of death in the pediatric population. Bronchial rupture is rare, but there are potentially severe complications. Establishing and maintaining a patent airway is the key issue in patients with bronchial rupture. Here we describe an innovative method for maintaining a patent airway.
CASE SUMMARY
A 3-year-old boy fell from the seventh floor. Oxygenation worsened rapidly with pulse oxygen saturation decreasing below 60%, as his heart rate dropped. Persistent pneumothorax was observed with insertion of the chest tube. Fiberoptic bronchoscopy was performed, which confirmed the diagnosis of bronchial rupture. A modified tracheal tube was inserted under the guidance of a fiberoptic bronchoscope. Pulse oxygen saturation improved from 60% to 90%. Twelve days after admission, right upper lobectomy was performed using bronchial stump suture by video-assisted thoracic surgery without complications. A follow-up chest radiograph showed good recovery. The child was discharged from hospital three months after admission.
CONCLUSION
A modified tracheal tube could be selected to ensure a patent airway and adequate ventilation in patients with bronchial rupture.
Core Tip: Tracheal intubation for traumatic bronchial rupture is difficult and complex. A modified tracheal intubation is a simple method to establish and maintain a patent airway for respiratory support in traumatic bronchial rupture. We treated a 3-year-old boy successfully using a modified tracheal tube which was inserted under the guidance of a fiberoptic bronchoscope.
