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Rev Esp Anestesiol Reanim (Engl Ed) ; 68(10): 597-601, 2021 12.
Article in English | MEDLINE | ID: covidwho-1510237


Iatrogenic tracheal rupture (ITR) is a serious complication secondary to procedures such as emergent orotracheal intubation or tracheostomy, among others. The management of ITR depends on the size, extension and location of the injury, along with the patient's respiratory status and comorbidities. The priority of treatment is to keep the airway permeable to ensure adequate ventilation. We present the case of a tracheal rupture after performing a percutaneous tracheostomy, in a patient diagnosed with severe acute respiratory distress syndrome secondary to bilateral interstitial pneumonia due to SARS-Cov-2. The issues are discussed, such as the management (conservative vs. surgical) depending on the features of the injury and the patient, in the extraordinary context that the COVID-19 pandemic has entailed.

COVID-19 , Respiratory Distress Syndrome , Humans , Iatrogenic Disease , Pandemics , Respiratory Distress Syndrome/etiology , Rupture , SARS-CoV-2 , Trachea/diagnostic imaging
Eur Rev Med Pharmacol Sci ; 25(14): 4835-4840, 2021 07.
Article in English | MEDLINE | ID: covidwho-1335541


OBJECTIVE: Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) follows a biphasic disease model consisting of an early viral response phase and an inflammation phase. SARS-CoV-2 has a high affinity for the upper respiratory tract and conjunctiva; hence, it can infect the upper respiratory tract and facilitate airway inflammation. COVID-19 also affects the tracheal epithelial cells. We hypothesized that the size of the trachea increases depending on the severity of the disease, and this increase is an indicator of poor prognosis. There are no studies on this subject in literature, to the best of our knowledge. For this purpose, in this study, the tracheas of 326 patients who reported to the radiology clinic were examined by evaluating the thoracic computed tomography (CT) images. PATIENTS AND METHODS: The patients who were admitted to the Malatya Training and Research Hospital between September and December 2020, had a positive SARS-CoV-2 nasopharyngeal reverse transcription-polymerase chain reaction result, and had undergone thoracic CT, were included in the study. The thoracic CT scans without respiratory artifacts were evaluated, and anteroposterior (AP) and transverse diameters of the trachea were measured at the thyroid and bifurcation levels. RESULTS: We believe that a tracheal AP diameter of >20 mm at the thyroid level and a tracheal AP diameter of 18 mm at the thyroid bifurcation level (according to Group 3 and Group 4) may be indicators of poor prognosis. In terms of survival, a tracheal AP diameter of >18 mm at the bifurcation level can be considered as a poor prognostic factor. CONCLUSIONS: The tracheal diameter may increase in proportion to the severity of inflammation, indicating or accompanying a poor prognosis. Patients with extensive involvement should be monitored closely for the development of tracheal stenosis.

COVID-19/diagnostic imaging , SARS-CoV-2 , Trachea/diagnostic imaging , Adult , Aged , Aged, 80 and over , Female , Hospitalization , Humans , Male , Middle Aged , Pilot Projects , Prognosis , Tomography, X-Ray Computed , Young Adult
JAMA Otolaryngol Head Neck Surg ; 147(5): 485, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1100839
JAMA Otolaryngol Head Neck Surg ; 147(5): 484-485, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1100838
Intern Med ; 60(3): 473-477, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1067517


We experienced two cases of post-intubation laryngotracheal stenosis (PILS) occurring in patients after acute coronavirus disease (COVID)-19 in a relatively narrow time period. The patients required mechanical ventilation for 9 days in one and 28 days in the other. In both cases, the patients were discharged but later developed symptoms of cough and dyspnea, which were later diagnosed as PILS. Persistent cough and dyspnea are common symptoms in both PILS and the recovery phase of severe COVID-19. For this reason, PILS should be considered in the differential diagnosis post-COVID-19 patients. In addition, the prevalence of PILS may be greater than that of other critical diseases in severe COVID-19 patients.

COVID-19/complications , Intubation, Intratracheal/adverse effects , Tracheal Stenosis/etiology , Adult , Cough/etiology , Dyspnea/etiology , Female , Humans , Laryngoscopy , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Radiography, Thoracic , Respiration, Artificial , SARS-CoV-2 , Tomography, X-Ray Computed , Trachea/diagnostic imaging , Tracheal Stenosis/diagnosis , Tracheal Stenosis/diagnostic imaging
J Thorac Cardiovasc Surg ; 163(1): 324-325, 2022 01.
Article in English | MEDLINE | ID: covidwho-956528